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Downloadable WIC Forms

Mom holding baby

To print a form, click on it and select 'Print' from the 'File' menu.
Instructions: Print all appropriate forms and send to:

Warren County WIC
1340 State Route 9
Lake George, NY 12845

You can also bring completed copies of the forms with you to your appointment.

If you have any questions, please call us at (518) 761-6425.

Evening and lunch time appointments are available for working families.

Women

Medical Referral Form

Woman, Infant, or Child

Medical Documentation for WIC Foods/Formula
WIC Proxy Authorization Form (What is a proxy?)
WIC Medical Referral Form for Infants and Children
WIC Approved Formulas
WIC Acceptable Food Card

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