WIC and Nutrition Services Forms Available from DHSS Warehouse
Updated on 11/15/2024
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47 forms in this list.| Catalog Number | Name | Quantity Per Unit | Program | Restrictions |
| WIC-1 | WIC CERTIFICATION BACKUP FORM FOR INFANTS | PKG/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-10 EN/SP | PARTICIPANTS RIGHTS AND RESPONSIBILITIES-ENGLISH/SPANISH | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-10 LAM | PARTICIPANTS RIGHT AND RESPONSIBILITIES, LAMINATED YELLOW CARD | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-1526-EN | STARTING YOUR BABY ON SOLIDS, EN | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-1526-SP | STARTING YOUR BABY ON SOLIDS, SP | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-19 | WIC NOTIFICATION OF INELIGIBILITY OR TERMINATION | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-19 SP | NOTIFICATION OF INELIGIBILITY, SP. | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-2 | WIC CERTIFICATION BACKUP FORM FOR WOMEN | PKG/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-25 | SIGNATURE PAD BACKUP FORM | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-26 | WIC-26 WIC SHOPPER POSTER EN | Each | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-26 SP | WIC-26 SP WIC SHOPPER POSTER, SP | EACH | WIC and Nutrition Services | |
| WIC-27 | MEDICAL DOCUMENTATION FORM, REVISED, 6-2020 | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-30-M | PROOF OF ELIGIBILITY,MOWINS BACK UP | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY/ 5 PADS |
| WIC-371-EN | EASY PUREES ENGLISH | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-371-SP | EASY PUREES SPANISH | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-39 | JUST A REMINDER | EACH | WIC and Nutrition Services | PROGRAM USE ONLY/ |
| WIC-39 SP | JUST A REMINDER CARD, SPANISH | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-456-EN | HEALTH TIPS FOR ACTIVE PLAY | PAD | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-456-SP | HEALTHY TIPS FOR ACTIVE PLAY-SPANISH | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-457-EN | TIPS FOR PREGNANT MOMS ENGLISH | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-457-SP | SPANISH, TIPS FOR PREGNANT MOMS | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-50 | READING YOUR EWIC RECEIPT | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-58 | MISSOURI WIC ONE PAGE OUTREACH | PAD/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-61 | WIC REFERRAL FORM | PAD/ | WIC and Nutrition Services | |
| WIC-62 EN | WIC SHOPPER BROCHURE ENGLISH | PKG/ | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-62 SP | WIC SHOPPER BROCHURE SPANISH | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-63 | LOW FAT MILK, 12OZ. CUPS, BLUE | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-64 | APPEAL & FAIR HEARING POSTER | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640 | WIC APPROVED FOOD LIST, EFFECTIVE OCT.,2018 | PACK | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640 SP | WIC APPROVED FOOD LIST,SPANISH | PK 2 | WIC and Nutrition Services | LIMIT/5 |
| WIC-640-A | WIC APPROVED FOOD LIST ARABIC | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640-B | WIC APPROVED FOOD LIST BOSNIAN | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640-C | WIC APPROVED FOOD LIST CHINESE | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640-D | WIC APPROVED FOOD LIST DARI | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640-K | WIC APPROVED FOOD LIST KOREAN | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640-P | WIC APPROVED FOOD LIST PASHTO | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640-S | WIC APPROVED FOOD LIST SAMOLI | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-640-U | WIC APPROVED FOOD LIST URDU | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-67 | PRIVACY POLICY POSTER, MISSOURI WIC PROGRAM | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-68 | MOVING TO ANOTHER STATE,POSTER | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-71 | MISSED APPOINTMENT CARD | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-71 SP | MISSED APPOINTMENT CARD, SPANISH | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-72 | AND JUSTICE FOR ALL (USDA CIVIL RIGHTS POSTER) | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-84 | DSS OUTREACH POSTCARDS | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |
| WIC-877-EN | REDUCING THE RISK OF CHOKING IN YOUNG CHILDREN AT MEALTIME | PAD/ | WIC and Nutrition Services | |
| WIC-877-SP | REDUCING RISK OF CHOKING IN YOUNG CHILDREN AT MEALTIME,SPANISH | EACH | WIC and Nutrition Services | |
| WIC-89 | LA FLYER FRUITS & VEGETABLES | EACH | WIC and Nutrition Services | PROGRAM USE ONLY |