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Health-Care Providers

 

Requesting Formula and Foods

WIC can provide noncontract formula and modified food packages when needed.* Before requesting a noncontract formula, check the list of WIC contract formulas below to see if WIC already offers a formula that is appropriate for your patient. If there is not a suitable choice, OR if you need to request any type of formula for a patient over 12 months of age (contract or noncontract), you’ll need to complete a request form. Click on the appropriate link below for instructions:

How to Request Noncontract Formulas

How to Request Metabolic Formulas

How to Request Soymilk, Tofu, or Gluten-Free Cereal

*Please note: all requests for noncontract formula are subject to approval by the Texas WIC program. This approval process is designed to help providers offer the best care for WIC participants. WIC is able to approve most requests for formulas that are listed in the Texas WIC Formulary and have the proper medical documentation based on reasons for issuance as noted in the Texas WIC formulary.

Other helpful links:

WIC Formula and Food Benefits – WIC is a supplemental food program. This page lists the food and formula benefits WIC participants receive each month.

Frequently Asked Questions – Common questions related to formula requests.

Texas WIC contract formulas are available without medical documentation to WIC participants under 12 months of age.

Similac Advance
milk-based
Similac Advance milk-based
Similac Sensitive low lactose
Similac Sensitive low lactose
Similac for
Spit-Up
milk-based,
lactose-free
Similac for Spit-Up milk-based, lactose-free
Similac Isomil Soy
soy-based
Similac Isomil Soy soy-based

After October 1st, 2012, Gerber Good Start Soy will be issued without medical documentation instead of Similac Isomil Soy.
Gerber Good Start Soy
Gerber Good Start Soy

Click here for more information about Texas WIC contract formulas.