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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
F-11077 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) 01/2018 PDF English No
F-11077 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) 01/2018 Word English No
F-11077A Prior Authorization/Preferred Drug List (PA/PDL) for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Instructions 01/2022 PDF English No
F-00081 Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents—Buprenorphine 07/2024 Word English No
F-00081 Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents—Buprenorphine 07/2024 PDF English No
F-00081A Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents—Buprenorphine Instructions 07/2024 PDF English No
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists 04/2022 PDF English No
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists 04/2022 Word English No
F-01673A Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists, Instructions 04/2022 PDF English No
F-11078 Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Capsules, Suspensions, and Non-Orally Disintegrating Tablets 07/2022 PDF English No
F-11078 Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Capsules, Suspensions, and Non-Orally Disintegrating Tablets 07/2022 Word English No
F-11078A Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Capsules, Suspensions, and Non-Orally Disintegrating Tablets Instructions 07/2022 PDF English No
F-00433 Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets 07/2022 PDF English No
F-00433 Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets 07/2022 Word English No
F-00433A Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets Instructions 07/2022 PDF English No
F-00315C Prior Notice and Consent for Evaluation and Assessment 03/2017 PDF English No
F-00315C Prior Notice and Consent for Evaluation and Assessment 03/2017 Word English No
F-00315C Prior Notice and Consent for Evaluation and Assessment, Spanish 03/2017 PDF Spanish No
N/A Priority Health Needs of Wisconsin Women 08/2015 PDF English No
F-11252 Private Duty Nursing for Members for Ventilator-Dependent Life-Support Addendum 05/2019 PDF English No
F-11252 Private Duty Nursing for Members for Ventilator-Dependent Life-Support Addendum 05/2019 Word English No
F-11041 Private Duty Nursing Prior Authorization Acknowledgment 10/2008 Word English No
F-11041 Private Duty Nursing Prior Authorization Acknowledgment 10/2008 PDF English No
P-01665 Private Duty Nursing Terms of Reimbursement 10/2021 PDF English No
P-01664 Private Duty Nursing to Ventilator-Dependent Members Terms of Reimbursement 10/2021 PDF English No

Glossary

 
Last revised August 16, 2024