Get Colorado Wic Program Materials Order Form - Colorado

Filling out the Colorado WIC Program Materials Order Form is essential for users seeking to provide necessary materials for the Women, Infants, and Children program. This guide offers detailed instructions to simplify the process and ensure that you have all the necessary information ready to make your order efficiently.

Follow the steps to complete the order form online easily.

1. Click ‘Get Form’ button to access the form and open it for editing.
2. Fill in the clinic name, providing the official name of the clinic that is placing the order.
3. Complete the clinic address with the full street address including any applicable number, city, and zip code for proper delivery.
4. Enter the name of the person placing the order to indicate who is responsible for this submission.
5. Specify the return address for the completed order form, which should be listed as the Colorado Department of Health and Environment, WIC Program, located at 4300 Cherry Creek Drive South, Denver, Colorado 80246.
6. Provide the date received at the State WIC Office, leaving a space for this information to be added later.
7. Fill in the clinic number which is usually assigned by the WIC program.
8. Include the clinic's phone number to allow the WIC program to reach out if necessary.
9. Provide an email address for electronic communication regarding the order.
10. Utilize the order key section to indicate the status of the items ordered. This includes whether the item was sent as ordered, back ordered, under revision, or if a full order is not available.
11. List the participant materials by their assigned codes and descriptions, ensuring that you check the appropriate items you wish to order.
12. Finally, review all entered information, save the changes, and then download or print the completed order form for your records.

Submit your order form online today to ensure you receive the necessary materials for the Colorado WIC Program.