Skip to main content

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
F-11020 Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS1) 05/2013 PDF English No
F-11020 Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS1) 05/2013 Word English No
F-11020A Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS1) Completion Instructions 02/2016 PDF English No
F-11021 Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS2) 07/2012 Word English No
F-11018 Prior Authorization Request Form (PA/RF) 05/2013 Word English No
F-11018 Prior Authorization Request Form (PA/RF) 05/2013 PDF English No
F-00787 Prior Authorization Requirements Exemption Request for Computed Tomography (CT), Magnetic Resonance (MR), and Magnetic Resonance Elastography (MRE) Imaging Services 02/2019 Word English No
F-00787 Prior Authorization Requirements Exemption Request for Computed Tomography (CT), Magnetic Resonance (MR), and Magnetic Resonance Elastography (MRE) Imaging Services 02/2019 PDF English No
F-11083 Prior Authorization/Brand Medically Necessary Attachment (PA/BMNA) 04/2017 PDF English No
F-11083 Prior Authorization/Brand Medically Necessary Attachment (PA/BMNA) 04/2017 Word English No
F-11083A Prior Authorization/Brand Medically Necessary Attachment (PA/BMNA): Completion Instructions 04/2017 PDF English No
F-11049 Prior Authorization/Drug Attachment (PA/DGA) 01/2024 PDF English No
F-11049 Prior Authorization/Drug Attachment (PA/DGA) 01/2024 Word English No
F-11049A Prior Authorization/Drug Attachment (PA/DGA), Instructions 01/2024 PDF English No
F-11054 Prior Authorization/Enteral Nutrition Formula Attachment (PA/ENFA) 06/2023 PDF English No
F-11054 Prior Authorization/Enteral Nutrition Formula Attachment (PA/ENFA) 06/2023 Word English No
F-11054A Prior Authorization/Enteral Nutrition Formula Attachment (PA/ENFA), Completion Instructions 06/2023 PDF English No
F-00212 Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment 02/2010 PDF English No
F-00212 Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment 02/2010 Word English No
F-00212A Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment Instructions 12/2019 PDF English No
F-11034 Prior Authorization/Physician-Administered Drug Attachment (PA/PAD) 07/2022 PDF English No
F-11034 Prior Authorization/Physician-Administered Drug Attachment (PA/PAD) 07/2022 Word English No
F-11034A Prior Authorization/Physician-Administered Drug Attachment (PA/PAD) Instructions 07/2022 PDF English No
F-11075 Prior Authorization/Preferred Drug List (PA/PDL) Exemption Request 07/2023 PDF English No
F-11075 Prior Authorization/Preferred Drug List (PA/PDL) Exemption Request 07/2023 Word English No

Glossary

 
Last revised August 16, 2024