Referral to Baltimore City WIC Program
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Use this form to refer pregnant women, postpartum women, and families with infants and children up to age 5. WIC provides supplemental healthy food benefits, breastfeeding support and nutrition education.

All WIC services are free if eligible.

Connect with Baltimore City WIC on Facebook
http://m.facebook.com/Baltimore-City-WIC-Program-205956892776901/.

Please call 410-396-9427 to contact the Baltimore City WIC Program.
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Welcome to WIC
Welcome to WIC (Espanol)
WIC Prescreening Tool
Please complete this prescreening tool to determine your eligibility status.

https://wic.fns.usda.gov/wps/pages/preScreenTool.xhtml
Is Mom or Child(ren) currently enrolled in the WIC Program?
Clear selection
Mom/Head of Household First and Last Name *
Mom/Head of Household Date of Birth *
Is Mom pregnant? *
Are there children in the household, under 5 years old?
Clear selection
Would you like to receive breastfeeding information?
Clear selection
Contact Telephone Number *
Cell Phone Carrier (example T-Mobile, Verizon, etc.)
Mom/Head of Household Email Address
Home Address (type your answer) *
Zip Code *
USDA Discrimination Statement
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

(1) mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
(2) fax: (202) 690-7442; or
(3) email: program.intake@usda.gov.

This institution is an equal opportunity provider.
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