A physician’s prescription for special formula will NOT be accepted.
New Medical Documentation forms must be completed by a physician for infants to receive special WIC formula; for women and children 1 year and older to receive formula; or for customization of WIC foods for women and children with special dietary needs.
Medical Documentation Forms
These WIC formulas do not require Medical Documentation for infants less than 12 months of age:
- Enfamil Premium LIPIL
- Prosobee LIPIL with Iron
- Gentlease LIPIL
- Enfamil AR LIPIL