Plattsburgh, NY

                                                                                                                                                                         

WIC FORMS

               


Downloadable WIC Forms

 To print a form, click on it and select 'Print' from the 'File' menu or click on the Acrobat print icon.

Instructions: Print all appropriate forms and send to:

Clinton County Health Department
Nutrition Unit
133 Margaret Street
Plattsburgh, NY 12901

If you have any questions, please call us at (518) 565-4830.
 

                 
 


Women

Medical Referral Form
 


Infant / Child

Medical Referral Form

 


Women, Infant or Child

Medical Documentation for WIC Foods/Formula
Acceptable Foods (Food Card)  (eff. July 2010)
WIC Proxy Authorization Form






 

                                                                                                                                                             

           Note:  These are external web links.


Clinton County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, religion, age or disability in employment or the provision
of services. The information on the Clinton County Health Department website is for educational purposes only. Nothing on the pages of this site shall be construed
as medical, fitness, dietetic, or other professional advice. This information is based on current beliefs among researchers and research studies published in the
current scientific literature. Clinton County is not responsible for, nor does it necessarily endorse any content on external web links.

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