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WIC program Document Uploads

Please DO NOT come to your WIC appointment due to the pandemic our office is closed to the public. We will call you at your scheduled appointment time. Please allow up to 60 minutes to complete your certification over the phone and upload your documents BEFORE your scheduled appointment. For your eWIC ID please reference the email you received from [email protected].

Caregiver’s Name *

Caregiver’s DOB *

Month

Day

Year

Location *

eWIC ID # *

Caregiver's Identification

Driver’s license, Medicaid card, Photo ID, OR School ID

upload document

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf.

Proof of Family Income (multiple documents may be uploaded)

Medicaid card, DCF benefit letter, the most recent month of paystubs, OR tax return (if self-employed).

upload document

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf.

Proof of Address

Current (within last 30 days) Letter/envelope, Utility bill, Rent receipt, OR Lease agreement.

upload document

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf.

Child/Children's ID (multiple documents can be uploaded)

Medicaid card, Immunization record, Birth Certificate, Birth confirmation letter, OR Foster/adoption paperwork.

upload document

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf.

Leave this field blank

Upcoming Events

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Mon, 04/19/2021 - 8:00am

Release of Records

Release of Information Authorization form

Autorización de Divulgación de Información

Questions? Send email to [email protected]

WIC program Document Uploads

Upcoming Events

COVID-19 Testing

COVID-19 Testing

Walk-in Clinic Closed

COVID-19 Testing

COVID-19 Testing

Release of Records

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WIC program Document Uploads

Upcoming Events

COVID-19 Testing

COVID-19 Testing

Walk-in Clinic Closed

COVID-19 Testing

COVID-19 Testing

Release of Records