WIC Prescriptions

About WIC Prescriptions

Federal regulations require WIC to obtain detailed prescriptive instructions from medical providers about which therapeutic formulas and WIC supplemental foods to provide to clients. We have developed the WIC medical documentation forms to make it easier for medical providers to give WIC staff all the required information.

WIC will accept prescriptions for foods and formula only when written on a WIC Medical Documentation Form. Prescriptions written on prescription pads won't be accepted.

What information is needed?

When a client needs a therapeutic formula or medical food, WIC requires a completed WIC Medical Documentation Form that:

  • Identifies the name of the product.
  • Provides a medical diagnosis.
  • Indicates how long the prescription is good for (up to a maximum of six months).
  • Provides contact information.
  • Is signed and dated by a healthcare provider with prescriptive authority.

In addition to the above, WIC requires healthcare providers to prescribe as needed:

  • The amount of therapeutic formula or medical food needed per day for each product prescribed.
  • Any regular WIC approved food(s) and their prescribed amounts for medically fragile women and children with qualifying condition(s). Clients who need a therapeutic formula will also be eligible to receive any WIC approved supplemental foods, including milk.

Why do WIC federal regulations require prescriptions for foods?

The federal rules are developed to ensure the client's healthcare provider has determined whether any foods WIC are medically contraindicated. Requiring the health care provider to prescribe the types and amount of WIC formula and supplemental foods allowed in the client's diet will help WIC staff provide a food package that is appropriate to the client's medical needs.

WIC Medical Documentation Forms

Qualifying Conditions

Qualifying conditions include, but aren't limited to premature birth, low birth weight, failure to thrive, inborn errors of metabolism and metabolic disorders, gastrointestinal disorders, malabsorption syndromes, immune system disorders, disease and medical conditions that impair ingestion, digestion, absorption or the utilization of nutrients. Medical foods, medical formulas or whole milk (for children and women) can't be issued for the purposes of managing body weight.

Supplemental Foods

Supplemental foods include: milk, cheese, tofu, soy beverage, fresh fruits and vegetables, whole grain bread, whole corn tortillas, bulgur, breakfast cereals, juice, peanut butter, canned or dried beans, eggs for children and women. In addition, exclusively breastfeeding women receive tuna, sardines, or canned salmon. Infants receive infant formula only if needed, and after six months of age, receive baby foods and cereal. View a complete list of Washington State WIC Nutrition Program's foods.