WIC Rights & Responsibilities

Rights and Responsibilities Forms

Each WIC client, or the client's caregiver, is required to sign the WIC Rights and Responsibilities Form at each certification appointment to indicate their understanding and agreement to follow the program rules. Staff review this form with each client or caregiver to assure they are informed of the WIC Nutrition Program's expectations of them, and to notify them about what they can expect from WIC.

Unless otherwise noted, all materials and forms on this page are in PDF format.

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Documents posted in PDF format on the Department of Health Web site will be made available on request to users who are unable to download or view them. For persons with disabilities, PDF documents will be made available on request in other formats. To submit a request, contact WIC's Web Coordinator. Download the free PDF viewer here.

In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410 or call 800-795-3272 (voice) or 202-720-6382 (TTY). USDA is an equal opportunity provider and employer.

Washington WIC does not discriminate.

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WIC Program
Washington State Department of Health
PO Box 47886
Olympia, Washington, 98504-7886

Last Update:  10/02/2009 12:31 PM
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