Women Infants and Children (WIC) Referrals | DeKalb County Health Department

WIC Families – Referral Form

WIC is the Special Supplemental Nutrition Program for Women, Infants, and Children funded by the United States Department of Agriculture. It is commonly referred to as the WIC Program. County health departments, community and rural health centers, and community action agencies provide WIC Program services. WIC provides nutrition education, breastfeeding support, healthy food, health referrals and other services free of charge to Illinois families who qualify. The WIC Program promotes healthy habits and healthy families to pregnant, breastfeeding and postpartum women, infants and children until age 5. After filling out and submitting this form, the Illinois DeKalb County Health Department WIC clinic will contact you within 5 business days though typical response time is much sooner.

Name/Nombre(Required)

First Name/Primer nombre Last Name/Apellido

Date of Birth/Fecha de nacimiento(Required)

Phone/Telèfono(Required)

Email/Correo Electrònico(Required)

Category/Categorìa(Required)

Preferred Language/ Idioma Preferido(Required)

Heard about WIC or Referred By/Còmo Escuchò Sobre WIC o Referido Por(Required)

Women, Infants and Children (WIC) Referrals

WIC Families – Referral Form