WIC Health Care Providers

page description

• Nebraska WIC Contract Formulas - these formulas do not require a PAF
• Nebraska WIC Formulary - this is a comprehensive list of all the formulas provided by WIC 
• Nebraska WIC formulary product reference guide with pictures

When is Medical Documentation Required?

For infants, the Infant PAF must be provided before WIC can issue:

1. Any formula other than NE WIC contract, standard infant formulas
2. Any specialized formula, as listed on the WIC Formulary
3. Any changes to foods provided in a standard six month infant food package
   
   Physician Authorization Form for Infants

• Any contract or specialty formula, as noted on the WIC formulary
• Whole milk for children > 2 years of age. This requires prescription of a specialized formula, as well
• 2% milk for children 1 year of age

     Physician Authorization for Children

When is Medical Documentation Required?

For pregnant, breastfeeding or non-breastfeeding women, a PAF must be provided before WIC can issue:

• Any specialized formula, as listed on the WIC formulary
• Whole milk, which also requires prescription of a specialized formula

    Physician Authorization Form for Women

Nebraska Food List & Shopping Guide

• Nebraska WIC Approved Food List - English (with new foods beginning 10.1.25)
  
• ​Nebraska WIC Approved Food List - Spanish (with new foods beginning 10.1.25)
• Food Brochure & Shopping Guide with Pictures - English​
• Food Brochure & Shopping Guide with Pictures - Spanish
  

Common food package examples and choices

• Common Sample Model Food Pack​age​s - Women & Children​ - (Effective 10.1.25)​​