Complaint Forms
- Make a complaint about your WIC service
- File a discrimination complaint with the USDA
- Formulario de Denuncia por Discriminación del Programa del USDA Departamento de Agricultura de los EE. UU.
WIC Forms
This page has been automatically translated from English. MSDH has not reviewed this translation and is not responsible for any inaccuracies.
Related resources
-
PDF [925KB]WIC Participant Complaint Form (Spanish) PDF [925KB]1114s
-
PDF [929KB]WIC Participant Complaint Form (Vietnamese) PDF [929KB]1114v
-
PDF [306KB]Request for Medical Formula for Infants PDF [306KB]Form 972
-
PDF [49KB]Request for Medical Formula for Women and Children PDF [49KB]Form 263
To view/print PDF documentation you will need Adobe Reader
Mississippi State Department of Health • 570 East Woodrow Wilson Dr • Jackson, MS 39216 • 866‑HLTHY4U • Contact and information
