Women, Infants and Children (WIC) Information for providers

WIC is committed to collaborating with other health care partners. To receive a visit from one of our WIC representatives, and to schedule a short presentation on WIC services, please contact Joycelyn Mendoza at [email protected].

Refer a patient to WIC 

Providers should complete this WIC pediatricpregnancy, or postpartum referral form and ask your patient to call WIC at (408) 792-5101 or text (888) 413-2698.

Providers and other community agencies should send a request for the patient with this WIC Program Enrollment Request Form and fax it to (408) 294-6315 or email [email protected] and WIC staff would reach out to the patient.

For other WIC offices in Santa Clara County, please contact Indian Health Center of Santa Clara Valley at (408) 960-0900, and Gardner Health Services at (408) 254-5197.

Refer a patient for breastfeeding support

Complete the WIC referral forms above and fax it to (408) 294-6315 or email [email protected]

Ask your WIC participants to call the WIC Breastfeeding Support line at (408) 794-0550.

Ask your non-WIC patients to call Nursing Mothers Counsel at (650) 327-6455

Visit the breastfeeding website for more information.

WIC-eligible nutritionals and therapeutic formulas

WIC recognizes and promotes breastfeeding as the optimal source of nutrition for infants. WIC encourages breastfeeding for one year and beyond. For women who do not fully breastfeed, WIC provides iron-fortified infant formula.

If one of the standard WIC contract formulas is not appropriate for your patient, refer patient to Medi-Cal for medically necessary formula or medical food. When these products are not a covered benefit for Medi-Cal, health care providers may send the request to WIC. 

Check the therapeutic formula flyer and learn more below:

    1. Refer patient to health plan or pharmacy
    2. Submit medical justification
    3. Wait for approval
    4. If approved, accept formula shipment and reorder monthly
    5. if denied, unavailable, or in a pending status, complete the WIC Medical Formula and Nutritional Request Form and refer the request to WIC

    A WIC Medical Formula and Nutritional Request Form must be completed by the health care provider every three to six months for a prescribed medical formula and nutritionals for patient receiving formula from any sources, or for requesting medical formula and nutritionals from WIC. Visit CDPH WIC Health Care Providers webpage for more information.

    As of August 1, 2022, the standard WIC infant formula has changed. The new milk-based formula is Similac. The soy-based Enfamil formula and therapeutic formulas offered remains the same. For more information, visit the Infant Formula Transition Webpage for WIC Families.

    WIC Home Page and Locations

    Women, Infants, and Children (WIC) Program

    Main Telephone: (408) 792-5101

    Texting Number: (888) 413-2698   

    Fax Number: (408) 294-6315   

    Email: [email protected]

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