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Get Ohio Department Of Health Wic Program Application
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How to fill out the Ohio Department Of Health WIC Program Application online
This guide provides step-by-step instructions on how to complete the Ohio Department Of Health WIC Program Application online. By following these instructions, you can ensure that your application is filled out accurately and efficiently.
Follow the steps to successfully complete your application.
- Click ‘Get Form’ button to obtain the application form and access it in the editor.
- Fill in the personal details in section A, including the name, street address, telephone numbers, and county. Ensure the information is complete and accurate.
- In section B, list all individuals living in your home. Include their full names, indicate if they are Hispanic/Latino, and provide their relationship to you. Repeat this for all individuals in your household.
- If applicable, answer questions regarding pregnancy and breastfeeding status, including providing due dates and doctor’s information where requested.
- Indicate whether anyone in your home is currently receiving assistance such as Ohio Works First Cash, Medicaid, or Food Assistance. Provide names where required.
- Document the income sources for each person in your household. List the name, source of income, gross amounts, and how often it is received.
- Ensure that you and any individuals who assisted you sign the form as required. This includes signing on the back of the application.
- Once all sections are complete, you can save the changes, download the application, print it, or share it as needed.
Take the next step and complete your Ohio Department Of Health WIC Program Application online today.
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Who is eligible? Pregnant, postpartum and breastfeeding women, infants, and children up to age five are eligible. They must meet income guidelines, a state residency requirement, and be individually determined to be at "nutritional risk" by a health professional.
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