Forms
Farmers' Markets and Farm Stands Applications
- Application and Agreement for Farmers' Market Nutrition Program
(SF 52585 - printable only) - Application and Agreement for FMNP Indiana Market or Farm Stand
(SF 52586 - printable only)
Vendor Applications
- Vendor Application (SF 48064) and Food Price List (required with application)
- Pharmacy Formula Price List (required with application for pharmacy)
- Vendor Manual
WIC Clinic Forms
- What to bring to WIC Certification Appointment
- Food and Nutrition Service -113 Instructions
- Indiana WIC Disaster Plan
- Medical Documentation Forms:
Health Care Provider Letter
Children 1-5 Years of Age Medical Form
Infants up to 12 months Medical Form
Women Pregnant, Breastfeeding, and Non-Breastfeeding Postpartum Medical Form