Information for Health Care Providers

Memos:

Healthcare Professional Memo: New WIC Foods and Special Food and Formula Request Form

Healthcare Professional Memo: Anthro and Lab Information Request 

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 [Revised 3/26]
• WIC Anthropometric and Laboratory Information Request form

Resources for Providers:

• WIC Authorized Formula List (Effective 10/20/25) 
  
• 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.