Health Care Providers

When you refer clients to WIC, you are helping make a difference in the health of Florida’s women, infants, and children. Improving maternal and child health is a common goal you share with the WIC program. By referring potentially eligible women, infants, and children to the local WIC office, you will be providing a valuable service for your clients. Your clients who participate in WIC will receive free, professional nutrition services as well as healthy foods. The clients served by WIC are most vulnerable to the effects of poor nutrition and are most likely to benefit from the WIC program. Your help is needed to reach all potentially eligible clients.

Refer a Client to WIC

If you are a health care provider, please complete a Florida WIC Program Medical Referral Form for each client you are referring to WIC. Give the completed referral form to the client, and tell the client to call the local WIC office for an appointment. The client must bring the completed
referral form to the WIC certification appointment. Or, the form can be mailed or faxed to the local WIC office.

If you are not a health care provider, please have your client call the local WIC office for an appointment. The WIC office will assist the client in obtaining the required medical referral information.

Contact us for WIC forms and other materials or download them below.

Email: HillsboroughWICOutreach@flhealth.gov
Fax number 813-465-7067 or call 813-559-4431.

WIC Forms

Medical Documentation for Formula and Food Form
Medical Referral Form
Prenatal Weight Gain Grid for Singleton Pregnancy
Prenatal Weight Gain Grid for Multifetal Pregnancy

Program Information

Who is eligible for WIC and How to Apply
WIC Income Criteria
WIC Facts
Contract Infant Formulas
Refer your Clients to WIC booklet

Outreach Materials

WIC Outreach Pamphlet

English
Spanish
Haitian Creole

Are You Pregnant? flyer

English
Spanish