Dear Medical Provider: All of us want the best possible health outcomes for WIC patients.

Requests Together we can achieve optimal health outcomes for your WIC patients. We have a few requests.

The Medical Information You Provide Our entire staff uses the medical information you provide for many important purposes.

We counsel and educate your WIC patients regarding various aspects of health, discuss their options with them, follow their progress and make recommendations. The degreed nutritionists and dietitians in our Special Nutrition Department also reinforce any nutrition-related instructions you provide patients with chronic health conditions and reinforce any Medical Nutrition Therapy (MNT) instructions they receive.

Policies Our WIC staff follow policies created by the California Department of Public Health (CDPH), which oversees the statewide WIC Program. A few of these policies and procedures follow.

Prenatal and Postpartum Women—Our Procedures
• We advise all prenatal participants to strictly avoid alcohol.

• We ask all participants for the results of their hemoglobin or hematocrit tests performed at their prenatal and postpartum appointments.

• We ask all postpartum women with a recent history of gestational diabetes for the results of the two-hour oral glucose tolerance test done at their postpartum appointment.

Requests–Prenatal and Postpartum Women
• Please indicate on the appropriate referral form relevant medical conditions experienced by your WIC patient, whether prenatal or postpartum. View the Prenatal Referral Form here>> View the Postpartum Referral Form here>>

• Please refer all prenatal WIC patients with a nutrition-related medical condition (gestational diabetes, high blood pressure, thyroid condition) for medical nutrition therapy (MNT) with a dietitian in a non-WIC health care setting.

• Please ask any of your WIC patients who have received written MNT instructions outside of WIC to bring those dietary recommendations to WIC for re-enforcement and follow-up.

Infants and Children—A Few Procedures
• We use anthropometric data to monitor and assess children’s growth.

• We ask parents of a pediatric WIC patient with a low hemoglobin level for a new result in six months.

Requests–Infants and Children The medical information you share on the WIC Pediatric Referral Form assists us to provide the best possible services for your WIC patients. View a Pediatric Referral Form here>>

• Please indicate on our Pediatric Referral Form relevant medical conditions your WIC patient experiences.

• Ask parents to remove their children’s shoes before measuring their weight and height to ensure accuracy.

• Document current hemoglobin levels or hematocrit levels on the Pediatric Referral Form.

• We ask you to repeat the test determining hematocrit level or hemoglobin level every 12 months if the results indicate normal levels and every six months if results are abnormal.

• Please remember to inform parents when their children have a low hemoglobin level and to prescribe iron as needed.

Medical Nutrition Therapy Policy Performing MNT is outside the scope of WIC services. However if you send your WIC patient for MNT with a dietitian outside of WIC, our registered dietitians and degreed nutritionists, located at each WIC center, are available during follow-up visits to
reinforce the MNT dietary recommendations given to your WIC patient.

Thank you for your assistance.

To receive copies of any WIC forms, contact Charlene Walters at (323) 757-7244 ext. 298 or

To view our forms or contact our staff, access our WIC Referral Forms page>>