Find resources for staff and coordinators.
WIC staff
Forms
- Application - EN and SP
- Card inventory - monthly report
- Complaint or incident report
- Computer down kit
- Confidentiality agreement
- Conflict of interest
- Data request form
- Direct bill
- Health assessment
- Hospital breast pump request form
- Letter of ineligibility - EN and SP
- Letter of ineligibility - SP
- Medical documentation
- No proof and temporary (income) certification - EN and SP
- No proof and temporary (income) certification - SP
- Rights, responsibilities and consent - EN and SP
- Rights, responsibilities and consent - signature- EN and SP
- Verification of certification (VOC)
- Violation
Formula handbook
- Calculation guidance and examples
- Contact information and resources
- Direct bill training
- Formulas provided by Idaho WIC program
- How to conduct a search in the product guide
- Index of changes
- McKesson ordering protocol
- McKesson ordering QRC
- McKesson supply manager - PP
- Medical documentation form training
- Formula and nutritional issuance grid
- Policy reminders
- Product guide
- Rounding up procedure
- WIC formula overview - flowchart
Program data catalog
Policy manual
Policy manual - full version with supplements
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
- 152 Low head circumference
- 153 Large for gestational age
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 Mental illnesses
- 362 Developmental, sensory or motor disabilities interfering with the ability to eat
- 363 Pre-diabetes
- 371 Nicotine and tobacco use
- 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
- 901 Recipient of abuse
- 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
Nutrition risk criteria toolkit
WIC coordinators
Clinic site modification
Forms
New employee training checklists
Training lead information
- Anthropometrics
- Assign benefits
- Baby behavior
- Basic nutrition
- Breastfeeding
- Card and cardholders
- Care plan I
- Care plan II samples
- Case study appendix answers for trainer
- Child nutrition
- Computer system (WISPr)
- Confidentiality
- Customer service communication
- Directions
- Eligibility
- Food list
- Food packages
- Health and nutrition assessment
- Health and nutrition assessment advanced
- Health and nutrition assessment advanced sample
- Hematology
- Index of changes - guidebooks
- Issuing benefits
- Overview
- Participant centered education (PCE)
- Postpartum nutrition
- Prenatal nutrition
- Referrals
- Special authorization
MOUs, consents, & releases | confidentiality guidance