WIC Referral Forms Available Online


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NC WIC Referral Form Available Online
Self and Community Referral to WIC program is now available through website  

Beginning October 14, 2019, healthcare providers, social workers, and other community partners may refer individuals to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program through the use of an online referral form. Individuals may also refer themselves through the use of the form. Developed by the NC Nutrition Services Branch, the WIC referral form is a way of improving access to WIC and expanding ways that families and providers can communicate digitally with WIC.

The form is available at https://www.nutritionnc.com/wic/wic-referral.asp.

After completing the form, a WIC clinic nearby will contact the individual referred to the program within 10 – 20 business days.

WIC provides nutrition education, breastfeeding support, healthy food, health referrals and other services free of charge to North Carolina families who qualify. The WIC Program promotes healthy habits and healthy families to pregnant, breastfeeding and postpartum women, infants and children until age 5.

To learn more about the services offered by the WIC Program at the Cleveland County Public Health Center, please visit www.clevelandcounty.com/cchd/wic-nutrition or call 980-484-5170.

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