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WIC: Electronic and Available to Order

 Forms, Publications, and Other Documents

Below is a list of all WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) documents including electronic only and printed items available to order. Review the "Available to Order" column below to ensure availability in paper format. If the document is available to order in a paper version, there will be a "Yes" with a link to ordering instructions.

When you are searching for a document, enter the number or a portion of the title in the search box below. To narrow your search results even more, place quotation marks " " around search terms. For example: "Breastfeeding Peer Counselors"

Ordering instructions for local WIC agencies only:

  • Download and fill out the Forms/Publications Order, F-80025A. Order only as many as you will use in three to six months. For most items you should order in quantities of at least 50.
  • Email the completed order form to the WIC forms processor at dhsfmdphwic@dhs.wisconsin.gov. You will receive a confirmation email once your order has been processed.
Assigned Number Title Release Date File Type Language Available to Order
P-10071 Medicaid Purchase Plan 07/2024 PDF English No
F-10127 Medicaid Purchase Plan (MAPP) - Work Requirement Exemption 12/2023 PDF English No
F-10127H Medicaid Purchase Plan (MAPP) - Work Requirement Exemption, Hmong 12/2023 PDF Hmong No
F-10127S Medicaid Purchase Plan (MAPP) - Work Requirement Exemption, Spanish 12/2023 PDF Spanish No
F-01307 Medicaid Purchase Plan (MAPP) Eligibility Worksheet 08/2020 PDF English No
F-01317 Medicaid Purchase Plan (MAPP) Impairment Related Work Expense (IRWE) Worksheet 07/2014 PDF English No
F-10121 Medicaid Purchase Plan (MAPP) Independence Account Registration 06/2023 PDF English No
F-10121H Medicaid Purchase Plan (MAPP) Independence Account Registration, Hmong 06/2023 PDF Hmong No
F-10121S Medicaid Purchase Plan (MAPP) Independence Account Registration, Spanish 06/2023 PDF Spanish No
F-01318 Medicaid Purchase Plan (MAPP) Medicaid and Remedial Expenses (MRE) Worksheet 07/2014 PDF English No
F-10122 Medicaid Purchase Plan (MAPP) Member / Premium Information 07/2008 PDF English No
F-01316 Medicaid Purchase Plan (MAPP) Premium Calculation Worksheet 08/2020 PDF English No
N/A Medicaid Purchase Plan Evaluation 2011 Annual Report 01/2015 PDF English No
F-13024 Medicaid Purchase Plan Premium - Employer Wage Withholding Information and Instructions 07/2008 PDF English No
F-00332 Medicaid Purchase Plan Premium Information / Payment 08/2024 PDF English No
F-00332S Medicaid Purchase Plan Premium Information / Payment, Spanish 08/2024 PDF Spanish No
N/A Medicaid Purchase Plan Work Requirement Letter for COVID-19 04/2020 PDF English No
P-10071H Medicaid Purchase Plan, Hmong 07/2024 PDF Hmong No
P-10071S Medicaid Purchase Plan, Spanish 07/2024 PDF Spanish No
F-10106S Medicaid Qualified Medicare Beneficiary (QMB) Specified Low-Income Medicare Beneficiary (SLMB) / Specified Low-Income Medicare Beneficiary Plus (SLMB+) Approval Decision Notice, Spanish 07/2008 PDF Spanish No
F-10106 Medicaid Qualified Medicare Beneficiary (QMB) Specified Low-Income Medicare Beneficiary (SLMB) Specified Low-Income Medicare Beneficiary Plus (SLMB+) Approval Decision Notice 07/2008 PDF English No
F-10107 Medicaid Qualified Medicare Beneficiary (QMB) Specified Low-Income Medicare Beneficiary (SLMB) Specified Low-Income Medicare Beneficiary Plus (SLMB+) Negative Decision Notice 07/2008 PDF English No
F-10107S Medicaid Qualified Medicare Beneficiary (QMB) Specified Low-Income Medicare Beneficiary (SLMB) Specified Low-Income Medicare Beneficiary Plus (SLMB+) Negative Decision Notice, Spanish 07/2008 PDF Spanish No
P-03478A Medicaid Renewals for Older Adults - Flyer 07/2023 PDF English No
P-03478AH Medicaid Renewals for Older Adults - Flyer, Hmong 07/2023 PDF Hmong No

Glossary

 
Last revised August 16, 2024