For Healthcare Providers
If you would like to refer a patient to the WIC Program or request a therapeutic formula, please use the form(s) below:
- TN WIC Referral Form (PH-3151)
- Tennessee's Nutrition Related Qualifying Conditions
- Fillable Request for WIC Eligible Therapeutics (PH-4077)
- Tennessee WIC Program Formulary
The WIC supplemental foods that are offered to participants are aligned with the Dietary Guidelines for Americans and the American Academy of Pediatrics’ infant feeding guidance.