Information for Medical Providers

Medical providers: What you need to know about medical documentation required to request WIC Special Formulas/Foods

• List of Authorized WIC Formulas (Effective 11/1/12) 
• WIC Qualifying Medical Conditions  
• New Medical Documentation Form for medical providers authorized to write prescriptions:
  • Instructions for Special Formula/Food Requests   
  • Form DCH-1326 Michigan WIC Special Formula/Food Request Form [Revised 8/1/12] 

The Michigan WIC infant formula manufacturer contract with Mead Johnson Nutrition is effective November 1, 2011 through October 31, 2016.