To Assist You With Referrals

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• Referral for Pregnant Woman

• Referral for Postpartum Woman

• WIC Pediatric Referral Form

• WIC Pediatric and Special Dietary Requests (SDR) Form

• When Your Medi-Cal Patient Needs Formula for Medical Conditions (FMC), also known as Therapeutic Formula

If My Child Has Medi-Cal and Needs Therapeutic Formula

You may find these pages helpful:

• Our Breastfeeding Policy

• Formula for Medical Conditions

We are available to provide information and assistance:

Requests for Documents
Maria Padilla-Castro, BS
Chief, WIC Outreach and Provider Relations
mpadilla-castro@slahp.org
(323) 905-1252

Lactation Services
Breastfeeding Helpline
(323) 905-1248

Breastfeeding
Jenniffer Duran-West, MEd Admin., CLC
Breastfeeding Coordinator
jduran@slahp.org
(323) 757-7244 ext. 5939

Therapeutic Formula and Special Dietary Requests
Nancy Ann Damiani, MPH, RD, CLE
Special Nutrition Services Coordinator
ndamiani@slahp.org
(323) 757-7244 ext. 5937