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MASSACHUSETTS WIC NUTRITION PROGRAM REQUEST FOR SPECIAL FORMULA AND FOOD Participants Name: Date of Birth (DOB): / / Guardians Name: Weeks Gestation (for premature infants): Formula or medical food
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How to fill out massachusetts wic nutrition program

01
To fill out the Massachusetts WIC Nutrition Program, follow these steps:
02
Contact your local WIC office: Find the nearest WIC office in Massachusetts and call them to schedule an appointment.
03
Gather necessary documents: Collect all the required documents, including proof of identity, residency, and income. These may include your driver's license, utility bills, pay stubs, and others.
04
Attend the appointment: Show up for your scheduled appointment at the WIC office. Please arrive on time.
05
Provide information: During the appointment, you will be asked to provide personal and financial information for eligibility determination. Answer all the questions honestly and accurately.
06
Get assessed: A WIC staff member will assess your nutritional needs and discuss appropriate food packages and services.
07
Receive benefits: If you are found eligible, you will receive an electronic benefits transfer (EBT) card loaded with approved food items and vouchers for formula (if applicable).
08
Attend periodic appointments: As a WIC program participant, you will need to attend periodic appointments to reassess your eligibility and receive nutrition education and support.
09
Use benefits: Purchase eligible food items at authorized stores using your EBT card and use the formula vouchers as instructed.
10
Follow program guidelines: Adhere to the guidelines provided by the WIC program regarding nutrition, health, and using benefits.

Who needs massachusetts wic nutrition program?

01
The Massachusetts WIC Nutrition Program is available for the following individuals and families:
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- Pregnant women
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- Breastfeeding women (up to the infant's first birthday)
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- Postpartum women (up to six months after the birth)
05
- Infants
06
- Children under the age of five (including foster children)
07
It is designed to assist low-income individuals and families who have nutrition-related needs and are at risk of poor health outcomes.
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The Massachusetts WIC Nutrition Program is a federally funded program that provides nutrition education, healthy food, and support to pregnant women, new mothers, and young children.
Pregnant women, new mothers, and young children who meet income guidelines are eligible to participate in the Massachusetts WIC Nutrition Program.
To apply for the Massachusetts WIC Nutrition Program, individuals must visit a WIC office, provide proof of identity, income, and residency, and undergo a nutrition assessment.
The purpose of the Massachusetts WIC Nutrition Program is to improve the health of pregnant women, new mothers, and young children by providing access to nutritious foods and nutrition education.
Participants in the Massachusetts WIC Nutrition Program must report income, residency, household size, and nutritional risk factors to determine eligibility.
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