WIC Referral Forms and Education Materials


Woman with children talking with health professional

The WIC items listed below are resources for WIC-eligible patients, health care teams, and community outreach. Some of these items come in select languages other than English and Spanish. 


To receive printed versions of the items below, send us a request.



WIC Referral Forms


Refer WIC-eligible patients to the San Bernardino County WIC program using the forms below. Information provided will be used by the WIC program to review your patient's health status and provide nutrition counseling. When completing each referral form, remember to:

  1. Include the patient's labs (hemoglobin and hematocrit, lead levels, height and weight).
  2. Make sure the form is completely filled out, signed, and dated before giving it to parents or caretakers.
  3. Contact WIC if you need the latest referral forms.


Pregnancy Referral Form

WIC Referral for Pregnant Women


Refer pregnant patients to San Bernardino County WIC.

Intended Audience:
Health care providers, clinic staff.

Dimensions: 8.5” x 5.5” form

Postpartum Referral Form

WIC Referral for Postpartum/Breastfeeding Women


Refer postpartum patients to San Bernardino County WIC.

Intended Audience:
Health care providers, clinic staff.

Dimensions: 8.5” x 5.5” form

Pediatric Referral Form

WIC Pediatric Referral


Refer infants and children to San Bernardino County WIC.

Intended Audience:
Health care providers, clinic staff.

Dimensions: 8.5” x 11” form

WIC Services Material


Share these WIC outreach materials with low to medium income families who may benefit from WIC services. Use the California Department of Public Health WIC Communications and Outreach Toolkit to promote WIC services on social media pages and websites. *Multiple languages other than Spanish may be available.


WIC Referral Guide for Health Care Providers

WIC Referral Guide for Health Care Providers


Information on how health care providers can work with WIC to reach their patient population.

Intended Audience:
Health care professionals only.

Dimensions: 8.5" x 11" pamphlet


* California Families Grow Healthy with WIC 


Information about WIC eligibility criteria and services.

Intended Audience:
Low to medium income families who live in California.

Dimensions: 3.8” x 8.5” brochure


Get WIC Services By Phone Flyer

Get WIC Services by Phone (COVID-19)


Shares how families can connect with WIC during the COVID-19 pandemic. The San Bernardino County WIC website and phone number are provided.

Intended Audience:
WIC-eligible and current WIC families.

Dimensions: 8.5” x 11” flyer


WIC is for Dads too! 


Information on WIC eligibility criteria for children who are cared for by single fathers, grandfathers, etc.

Intended Audience:
Fathers, stepdads, foster dads, uncles, and grandfathers who are the sole provider for their children.

Dimensions: 8.5” x 11” flyer


Find Your Local WIC 


Flyer with WIC locations. The San Bernardino County WIC website and phone number are provided.

Intended Audience:
Families who may benefit from WIC services.

Dimensions: 5.5” x 8.5” double-sided flyer


Families Grow Healthy with WIC Flyer

* California Families Grow Healthy with WIC! 


Information on WIC eligibility criteria and services.

Intended Audience:
Low to medium income families who may benefit from WIC services.

Dimensions: 8.5” x 11” flyer


Breastfeeding Materials


The following WIC materials focus on breastfeeding information and support. *Multiple languages other than Spanish may be available.


Breastfeeding & Returning to Work or School 


Tips on how to breastfeed at work or school, breastfeeding laws, and storing breast milk.

Intended Audience:
Parents and breastfeeding parents.

Dimensions: 8.5” x 11” booklet


Breastmilk Has More of What Babies Need 


A visual comparison of the benefits breastmilk has to offer over formula.

Intended Audience:
Pregnant and breastfeeding parents.

Dimensions: 3.8” x 8.5” double-sided flyer


Guide to Breastfeeding

* Guide to Breastfeeding


Positions for breastfeeding, tips for a good latch, getting support from family and friends, and a Question & Answer section.

Intended Audience:
Pregnant and breastfeeding parents.

Dimensions: 8.5” x 11” booklet


Breast and Nipple Candidiasis 


Reviews signs, symptoms and treatment protocols for candida of the nipple and/or breast. 

Intended Audience:
Health care providers, clinic staff.

Dimensions: 8.5” x 11” sheets


Breast Milk Supply and Infant Growth


Assessment protocols for evaluating milk supply and infant milk intake.  

Intended Audience:
Health care providers, clinic staff.

Dimensions: 8.5” x 11” sheets


Breastfeeding Pocket Guide for Health Care Providers


Includes prenatal care, how to provide breastfeeding support from delivery to discharge, and diagnosis codes. Limited quantity.

Intended Audience:
Health care providers, clinic staff.

Dimensions: 4” x 5.5” ringed pocket book


The Hospital Experience Booklet

The Hospital Experience


Provides information to parents on how to prepare for the hospital stay; before and after birth (hospital plan, breastfeeding support, skin-to-skin, etc.).

Intended Audience:
Pregnant parents.

Dimensions: 10" X 7" book


Infants and Toddler Development Material


Use the following WIC materials to educate caregivers about infant feeding practices and behavior. *Multiple languages other than Spanish may be available.


* Getting to Know Your Baby Booklet - Birth to 6 Months


Explains to parents how babies sleep, how to read their cues, and tips to calm their crying baby. Comes with a DVD to provide visual aids of what cues look like.

Intended Audience:
Parents and guardians of newborns.

Dimensions: 7.5” x 10” booklet


* Feed Me! 6-12 Months 


Shows examples of how much and what type of food to feed 6-12 month old infants. Allergies are also discussed. Healthy recipes using baby food are included.

Intended Audience:
Parents, guardians, and caregivers.

Dimensions: 7.5” x 10” booklet


* 5 Common Signs Your Baby is Ready for Solid Foods


Explains the signs babies show when they are ready to eat solid foods and tips for busy parents.

Intended Audience:
Parents or guardians of infants.

Dimensions: 5.5” x 8.5” double-sided handout


Healthy Eating Education Material


Use these WIC materials to educate caregivers about healthy eating practices. *Multiple languages other than Spanish may be available.


* Healthy Choices for Kids 


Healthy snack ideas, tips for getting kids physically active, and how to order healthier choices when occasionally ordering fast food.

Intended Audience:
Parents or guardians.

Dimensions: 5.5” x 9” folded handout


* Well Fed Means Less Lead


Explains the dangers of lead, and sources of calcium, iron, and vitamin C that can help protect the body from lead.

Intended Audience:
Parents or guardians.

Dimensions: 3.8” x 8.5” folded brochure


* Iron for Strong Blood


Includes sources of iron for infants, children, and adults, the importance of including iron in the diet, and a sample menu featuring iron rich foods.

Intended Audience:
Parents or guardians.

Dimensions: 5.5” x 9” folded handout


Choose Less Juice, More Water Handout

Choose Less Juice, More Water


Discusses how to introduce fruit juice to children ages one through six. Includes WIC eligibility information and services.

Intended Audience:
Parents or guardians.

Dimensions: 6” x 9” handout


facebook
pinterest
instagram
twitter
youtube

En Español
facebook
pinterest
youtube