Refer to WIC
Via EPIC or CARElink (preferred method)
If access to EPIC or CareLink is not available, please the online referral form (this form is also used by families who self refer).
Please inform families a referral will be/was made and that submitting the referral does not mean the family has been enrolled
- Refer postpartum WIC moms that need help with breastfeeding including support from IBCLC. The family will be contacted within 1-2 business days.
To be eligible for WIC services, WIC participants must provide proof of pregnancy (if applicable), height and weight measurements and blood work. This information is requested from the health care provider in order to encourage referrals to healthcare services. In many cases, height, weight and hemoglobin screening can be done at the WIC site as well.
California State WIC requires medical documentation for formula for premature and medically fragile infants. This includes any special formulas and nutritionals for older children.
For therapeutic formula referrals, please submit referral via EPIC or CareLink. If you do not have access to EPIC or CareLink, please email pediatric referral form to email@example.com.
- Pediatric Referral Form
- Pregnant Women Referral Form
- Postpartum Referral Form
- Outreach Materials for CA Non-WIC Programs Only
- Electric Breast Pump Referral Form