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WIC Rights & Responsibilities

Rights and Responsibilities Forms (PDF)

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.

WIC Rights and Responsibilities Form in Arabic
(440.86 KB)		 WIC Rights and Responsibilities Form in Chinese
(639.57 KB)
English
(181.29 KB)		 WIC Rights and Responsibilities Form in Korean
(757.04 KB)
WIC Rights and Responsibilities Form in Russian
(PDF, 665.46 KB)		 WIC Rights and Responsibilities Form in Somali
(651.32 KB)
WIC Rights and Responsibilities Form in Spanish
(749.42 KB)		 WIC Rights and Responsibilities Form in Vietnamese
(427.19 KB)

 

Documents posted in PDF version 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 Subsite Developer.  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:  03/25/2008 02:26 PM
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