Find resources for staff and coordinators.Â
WIC Staff
Forms
- Application - English and Spanish
- Card Inventory - Monthly Report
- Confidentiality Agreement
- Conflict of Interest
- Data Request Form
- Direct Bill
- Hospital Breast Pump Request Form
- Letter of Ineligibility - English and Spanish
- Letter of Ineligibility - Spanish
- Medical Documentation
- No Proof Temporary (Income) Certification - English and Spanish
- No Proof Temporary (Income) Certification - Spanish
- Order Forms
- Rights, Responsibilities and Consent - English and Spanish
- Verification of Certification (VOC)
- Violation
Formula Handbook
- Calculation Guidance and Examples
- Contact Information and Resources
- Coram and WIC Nutritional Products Process
- Direct Bill Training
- Formulas Provided by Idaho WIC Program
- How to Conduct a Search in the Formula Handbook
- Index of Changes
- Medical Documentation Form Training
- Formula and Nutritional Issuance Grid
- Policy Reminders
- Product Guide
- WIC Formula Overview - Flowchart
Policy Manual
- Chapter 01 - Overview and Organization
- Chapter 02 - Administration
- Chapter 03 - Caseload Management
- Chapter 04 - Eligibility and Certification
- Chapter 05 - Nutrition Education
- Chapter 06 - Breastfeeding Promotion and Support
- Chapter 07 - Food Delivery
- Chapter 08 - Staff Training
- Chapter 09 - Vendor Relations
- Chapter 10 - Monitoring
- Chapter 11 - Financial Management
- Computer Down Kit
- Definitions
- Fair Hearings
- Index of Changes
- Military Pay - LES
- Monitoring Forms
- MOU Sample
- RD Referrals
Program Data Catalog
Nutrition Risk Criteria
Anthropometric 100
- 101 Underweight (Women)
- 103 Underweight / at Risk of Underweight (I & C)
- 111 Overweight (Women)
- 113 Obese (Children 2-5 years)
- 114 Overweight / at Risk of Overweight (I & C)
- 115 High Weight-for-Length (I & C under 24 months)
- 121 Short Stature / at Risk of Short Stature (I & C)
- 131 Low Maternal Weight Gain
- 133 High Maternal Weight Gain
- 134 Failure to Thrive
- 135 Slowed / Faltering Growth Pattern
- 141 Low Birth Weight / Very Low Birth Weight
- 142 Preterm or Early Term Delivery
- 153 Large for Gestational Age
Biochemical 200
Clinical Health and Medical 300
- 301 Hyperemesis Gravidarum
- 302 Gestational Diabetes
- 303 History of Gestational Diabetes
- 304 History of Preeclampsia
- 311 History of Preterm or Early Term Delivery
- 312 History of Low Birth Weight
- 321 History of Spontaneous Abortion, Fetal or Neonatal Loss
- 331 Pregnancy at a Young Age
- 332 Short Interpregnancy Interval
- 334 Lack of or Inadequate Prenatal Care
- 335 Multi-fetal Gestation
- 336 Fetal Growth Restriction
- 337 History of Birth of a Large for Gestational Age Infant
- 338 Pregnant Woman Currently Breastfeeding
- 339 History of Birth with Nutrition Related Congenital or Birth Defect
- 341 Nutrient Deficiency or Disease
- 342 Gastrointestinal Disorders
- 343 Diabetes Mellitus
- 344 Thyroid Disorders
- 345 Hypertension and Prehypertension
- 346 Renal Disease
- 347 Cancer
- 348 Central Nervous System Disorders
- 349 Genetic and Congenital Disorders
- 351 Inborn Errors of Metabolism
- 352.1 Infectious Diseases - Acute
- 352.2 Infectious Diseases - Chronic
- 353 Food Allergies
- 354 Celiac Disease
- 355 Lactose Intolerance
- 356 Hypoglycemia
- 357 Drug Nutrient Interactions
- 358 Eating Disorders
- 359 Recent Major Surgery, Physical Trauma, Burns
- 360 Other Medical Conditions
- 361 Depression
- 362 Developmental, Sensory or Motor Disabilities Interfering with the Ability to Eat
- 363 Pre-Diabetes
- 371 Maternal Smoking
- 372 Alcohol and Substance Use
- 381 Oral Health Conditions
- 382 Fetal Alcohol Spectrum Disorders
- 383 Neonatal Abstinence Syndrome
Dietary 400
- 401 Failure to Meet Dietary Guidelines for Americans
- 411 Inappropriate Nutrition Practices for Infants
- 411.1 Justification - Inappropriate Nutrition Practices for Infants
- 425 Inappropriate Nutrition Practices for Children
- 425.1 Justification - Inappropriate Nutrition Practices for Children
- 427 Inappropriate Nutrition Practices for Women
- 427.1 Justification - Inappropriate Nutrition Practices for Women
- 428 Dietary Risk Associated with Complementary Feeding Practices
Environment and Other Factors 500+
- 501 Possibility of Regression
- 502 Transfer of Certification
- 601 Breastfeeding Mother of Infant at Nutritional Risk
- 602 Breastfeeding Complications or Potential Complications (Women)
- 603 Breastfeeding Complications or Potential Complications (Infant)
- 701 Infant up to 6 months old of WIC Mother or of a Woman Who Would Have Been Eligible During Pregnancy
- 702 Breastfeeding Infant of Woman at Nutritional Risk
- 801 Homelessness
- 802 Migrancy
- 902 Woman or Infant/Child of Primary Caregiver with Limited Ability to Make Appropriate Feeding Decisions and/or Prepare Food
- 903 Foster Care
- 904 Environmental Tobacco Smoke Exposure
WIC Coordinators
Clinic Site Modification
Forms
New Employee Training Checklists
Quarterly Reports
Training Lead Information
- Activities Workbook (Learner Copy)
- Anthropometrics
- Assigning Benefits and Special Authorization
- Baby Behavior
- Basic Nutrition
- Breastfeeding
- Card and Cardholders
- Care Plan I
- Care Plan II Samples
- Child Nutrition
- Computer System 101
- Confidentiality
- Customer Service Communication
- Directions
- Eligibility
- Food Packages
- Health and Nutrition Assessment
- Hematology
- Index of changes - Guidebooks
- Issuing Benefits
- Overview
- Participant Centered Education (PCE)
- Postpartum Nutrition
- Prenatal Nutrition
- Referrals