Medical Documentation

Medical documentation is federally required to ensure that WIC participants have a medical condition that requires the use of an exempt infant formula or medical food. Federally mandated changes to the WIC program starting October 1, 2009 necessitates health care providers to provide additional prescriptive information for participants receiving certain formulas, medical foods or milk substitutes. Federally mandated changes to the WIC program which started starting October 1, 2009 necessitates health care providers to provide additional prescriptive information for participants receiving certain formulas, medical foods or milk substitutes.

What’s new with WIC medical documentation?

  • Only the Medical Documentation Health Care Provider Authorization Form (WIC-27 form) will be accepted for issuing medical formulas or milk substitutes. This form is used by health care providers to request special formula for WIC participants. This form maybe completed electronically, printed and then faxed or hand delivered to the Local Agency.
  • Requests for special formulas written on physician scripts are not accepted.
  • Physicians have to authorize the issuance of supplemental foods for any participant receiving a medical formula.
  • Maximum approval length for medical formulas is 6 months.

Please work with your Local WIC Provider if you have specific questions about completing a WIC-27 form.

When is medical documentation required?
Medical documentation is required in the following situations:

  • Any participant receiving a medical formula (exempt infant formula or a medical food)
  • Any child receiving an infant formula
  • Medical Documentation (WIC-27) is required to issue whole milk to children (24 - 59 months old) and women; thus, whole milk can only be issued through Food Package III in addition to formula if a HCP prescribes whole milk

Additional Resources
Frequently Asked Questions