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Forms, Resources, and Referrals
Forms
- Anthropometric and Laboratory Information Request
- Client Agreement
- WIC EBT Card Issuance Log Spreadsheet
- Fair Hearing Procedure for Clients
- Formula Acceptance and Action Log
- Health and Diet Questionnaires
- Manually Assigned Risks (MAR) Tool
- Medical Conditions and Illnesses, revised 2/18
- Michigan Voter Registration Form: NSP-0938-B, NSP-938B-SP
Resources
- USDA Office of the Assistant Secretary for Civil Rights
- Federal Regulations
- Immunization Schedules (English) -CDC
- Immunization Schedules - Adults (English) - CDC
- Immunization Schedules (Spanish)-CDC
- Immunization Schedules - Adults (Spanish) - CDC
- USDA Website (State WIC Phone Numbers)
- Michigan Voter Information Center (state.mi.us)
Referrals
- Other Food Assistance Programs
- Pediatric Feeding Therapy Programs in Michigan
- Substance Use Prevention: Screening, Education and Referral Resource Guide for Local WIC Agencies