The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer.
Information for Health Care Providers
Memos:
Healthcare Professional Memo: Anthro and Lab Information Request
Healthcare Professional Memo: NEW WIC Special Formula/Food Request Form (revised 6-2023)
Healthcare Professional Memo: Return to Similac 1-30-23
- Healthcare Professionals Memo: Abbott Recall 2-23-22
- Healthcare Professionals Memo: Hypoallergenic and Specialty Formulas 4-26-22
- Similac PM 60/40 Information
Healthcare Professionals Memo - WIC Infant Formula Rebate Contract Change
Medical Documentation Forms for medical Providers authorized to write prescriptions:
- Instructions for Special Formula/Food Requests
- Form DCH-1326 Michigan WIC Special Formula/Food Request form [Revised 6/24]
- WIC Anthropometric and Laboratory Information Request form
Resources for Providers:
- WIC Authorized Formula List (Effective 8/1/24)
- WIC Materials Available to Michigan Maternal Child Health Partners
The current Michigan WIC infant formula manufacturer contract with Abbott Nutrition is effective November 1, 2021 through October 31, 2026.