WIC Baby/Child Nutrition Questions (6-23 months)

Form Template

The WIC Baby/ Child Nutrition Questions (6-23 months) Mobile App is designed for caseworkers who support the Department of Health Services

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Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The app is designed to help the mother and her children receive WIC assistance and supplements.

The simple to use questionnaire can be filled out by a WIC case manager from a PC or with a Smartphone or Tablet when sitting with a mother or family applying for WIC benefits.

The app can be used to capture the specific information about the recipient and baby, then using a checklist format, answer questions to assess the child's nutritional risk. Examples include: How is breastfeeding going? How do you make formula? How often does baby take bottle or formula? And other questions related to the child's health and other food the child eats.

The final document , signed by the WIC staff member, is saved securely on the Canvas Cloud. It can be printed or emailed directly to the WIC office to determine if the child is eligible for WIC benefits.

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