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  • 21514aform Pregnancy Wic Precertification Form

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Pregnancy WIC Precertification Application Please print all information. FAMILY DEMOGRAPHICS / MEMBERS Last name: First name: Middle initial: Date of birth: / / Is anyone in your family currently.

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Contact the Florida WIC Program Household Size*WIC Income Eligibility Based on Income Intervals1$25,142$4842$33,874$6523$42,606$8204$51,338$9886 more rows • Jun 24, 2022

Paycheck stubs dated within 30 calendar days of your appointment (example: weekly pay, bring four paycheck stubs) • Social Security benefits statement • Tax return IRS 1040 • Unemployment insurance benefit statement • Child support (e.g., court papers or history of payments) • Worker's compensation statement • ...

What to Take to Your WIC Appointment Medicaid, SNAP, or TANF form / letter. Driver's license. Social Security card. Foster placement letter. Picture I.D. (school, employee, or official) Military I.D. Passport or immigration records. Immunization record.

What to Take to Your WIC Appointment Medicaid, SNAP, or TANF form / letter. Driver's license. Social Security card. Foster placement letter. Picture I.D. (school, employee, or official) Military I.D. Passport or immigration records. Immunization record.

Texas WIC Income Guidelines Number of Household Members*Gross Monthly Household Income1$0 up to $2,2482$0 up to $3,0413$0 up to $3,8334$0 up to $4,6252 more rows

Use our Local Clinic Search to find a WIC office near you. Or you can call Toll free: 1-888-WIC-WORKS (1-888-942-9675) for automated information.

You can be enrolled in the Food Stamp Program and in WIC at the same time.

Your WIC office will schedule your WIC visits every 3 months to talk with you about nutrition and reload your WIC card with more food benefits.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232