Privacy and Consent to Share Information – Please read

In order to better serve you, we use third party automated messaging systems to contact you about your WIC appointments, offer online education, and other important WIC information. We need permission from you in order to use these providers.  Your information will be protected and will never be shared or used for any other purpose.   

I give my permission to the WIC Program to share name, date of birth, phone number and/or email address for all members of my household eligible for WIC.

This information will be shared with the following third party service providers:
·         One Call Now (automated calls, texts, emails)
·         Survey Monkey (online surveys)
·         Constant Contact (automated emails)

I understand that my choice to give consent or not will NOT affect my eligibility for or participation in the WIC Program, or the eligibility for or participation in the WIC Program of any children for whom I am legally responsible.

I understand that depending on my phone plan, there may be charges I will be responsible for. 

I understand that this agreement is effective for twelve months from the day I give consent and that I may cancel this agreement at any time by submitting a written cancellation notice to the WIC local agency.

* 1. Please indicate your choice below