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State Plan Section 2 200 Certification - Table of Contents

Income Eligibility Guidelines

WIC 200-00 Overview of Eligibility Requirements Policy

  WIC 200-00 Summary of Proof of Identity, Residency and Income Eligibility Procedures 05-2013

WIC 200-01 Certification Process and Applicant Processing Standards 12-2019

WIC 200-02 Physical Presence Requirement 01-2020

WIC 200-03 Identity Requirement Policy revision 12-2019

WIC 200-04 Residency Requirement Policy revision 11-2022

WIC 200-05 Categorical Eligibility Policy 

WIC 200-06 Income Eligibility Policy 2-2024

WIC 200-07 Income Eligibility Documentation Policy 2-2024

  WIC Eligibility Forms Summary

  Notice of Participant Action Form

  Arabic

  English

  Haitian

  Portuguese

  Spanish

  WIC Self-Declaration Form

  Arabic

English

  Haitian

  Portuguese

Spanish

  WIC Verification Form

  Arabic

English

  Haitian

  Portuguese

Spanish

WIC 200-08 Nutrition Assessment and Risk Determination 5-2024

  WIC 200-08 Sample Agreement for Professional Services

WIC 200-09 Lead Screening Requirement

WIC 200-10 Anthropometric Data 5-2024

  WIC 200-10 CT Prenatal Weight Gain Grid Form

WIC 200-11 Growth Chart Plotting of Premature Infants and Children CT-WIC update 12-2015

  WIC 200-11 Guidelines for GC & GA Adjustments for LBW & VLBW Infants

WIC 200-12 WIC Nutrition Assessment Screens and Guidance Policy 6-23-23

  WIC 200-12 BFPP Assessment Guidance 3-2023

  WIC 200-12 Child Assessment Guidance 3-2023

  WIC 200-12 Infant Nutrition Assessment Guidance 3-2023

  WIC 200-12 Prenatal Nutrition Assessment Guidance 3-2023

WIC 200-13 Completion of WIC Certification-Medical Referral Form Policy 01-2018

  WIC 200-13 Cert Med Ref Forms Infant-Child w-Guidelines revision 3-2024 (fillable forms)

  WIC 200-13 Cert Med Ref Forms Women w-Guidelines revision 3-2024 (fillable forms)

WIC 200-13 Supplement to Infant Children Certification Form 9-2023

  WIC 200-13 Supplement to Women Certification Form 9-2023

WIC 200-14 Mandatory Referrals during Certification 12-2021

CT WIC Selected Referrals Brochure 1-2022

  English

  Spanish

WIC 200-15 Immunization Screening Policy 09-2018

WIC 200-16 WIC Program Orientation Policy 12-2018

  WIC 200-16 Questions You May Have About WIC Food Benefits revised 12-2017

  WIC 200-16 Questions You May Have About WIC Food Benefits - Spanish

WIC 200-17 Certification Policy including Mid-Certification 10-2019

WIC 200-18 Use of the Regression Provision

WIC 200-19 Priority Assignment Policy

WIC 200-20 Transfer of Verification of Certification (VOC) 3-2024

WIC 200-21 Applicant and Participant Ineligibility Termination Disqualification Policy 07-2017

WIC 200-22 Disposition of Certification Files Policy 09-2016

WIC 200-23 Request for Caretaker Policy 02-2019

  WIC 200-23 Request for Caretaker Form revised 04-2019

  WIC 200-23 Request for Caretaker Form - Spanish revised 05-2019

WIC 200-24 Phenylketonuria or Metabolic Disorders CT WIC update 12-2015

WIC 200-25 Non-Resident Alien Participants 05-2012

WIC 200-26 Homeless Individual WIC Participants 11-2022

WIC 200-27 Special Populations 02-2016

WIC 200-28 Coordination of Services-Referral to Other Programs by WIC Staff 12-2021

  CT WIC Selected Referrals Brochure 1-2022

  English

  Spanish

WIC 200-29 Providing WIC Services to Foster Children 3-2024

WIC 200-30 Initiating Participant Waiting Lists 12-2015

WIC 200-30 Sample WIC Waiting List Letter - Child

  WIC 200-30 Sample WIC Waiting List Letter - PP Mother

WIC 200-31 WIC Participant Rights and Responsibilities Policy 5-2024

  WIC 200-31 WIC Participant Rights and Responsibilities Form - Arabic 05-2018

    WIC 200-31 WIC Participant Rights and Responsibilities Form - English 5-2024

  WIC 200-31 WIC Participant Rights and Responsibilities Form - Haitian 05-2018

  WIC 200-31 WIC Participant Rights and Responsibilities Form - Portuguese 05-2018

  WIC 200-31 WIC Participant Rights and Responsibilities Form - Spanish 05-2024

WIC 200-32 Separation of Duties 12-2016

WIC 200-33 Short Certification

WIC 200-34 Local Agency Non-Invasive HGB Testing Policy 05-2024

  WIC 200-34 Pronto Screening FAQs 05-2024

WIC 200-35 Eligibility Determination and Documentation under ARPA Waivers