Home Page Departments Department of Public Health Women, Infants and Children (WIC) WIC Referral Form

WIC Referral Form

*Last Name:

*First Name:

*Phone:

Ex: 999-999-9999

Best Available Time to for us to Reach You:

8 am - 11 am
11 am - 2 pm
2 pm - 5 pm

Preferred Language:

English
Spanish
Other Language:

Referred By:

Type the code from the image


Phone:	910-433-3730	Department of Public Health: 1235 Ramsey St Fayetteville, NC 28301
Fax:	910-433-3661
TTY Phone:	910-223-9386
Email:
Interim WIC Director:	Tamra Morris