Request for WIC Referral Forms and Education Materials


To send a request for printed WIC referral forms and education materials, complete the form below. Please refer to available WIC items listed on our WIC Referral Forms and Education Materials page. We can only fulfill material requests for organizations within San Bernardino County.


A WIC representative will review your submitted request and contact you during normal business hours.



WIC Material Request Form


For San Bernardino County offices
If you selected "Other" language, please fill out language required other than English or Spanish.
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En Español
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