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For Providers

Information for Physicians, Nurses, Dietitians, and other Health Care Providers

As a health care provider, you are a key partner in serving Georgia WIC participants. In this area, you will find information about recent changes in the Georgia WIC Program and access to new medical documentation forms and special formula resources.

New Medical Documentation Forms (Revised June 2012)

pdfMedical Documentation Form for WIC Special Formulas and Approved WIC Foods

pdfReferral Form and Medical Documentation for Special Food Substitutions


View the brief video presentation below to learn about changes to the Georgia WIC Program and the impact on your medical practice.

View the brief video presentation below featuring four case studies demonstrating how to complete the new Georgia WIC medical documentation forms.


For more information regarding Healthcare Providers and WIC visit

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Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits.  Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at:, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1)mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights. 1400 Independence Avenue, SW - Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email:

This institution is an equal opportunity provider.