Thank you for providing feedback about your experience at a WV WIC vendor. Contact information is not required, but this information does help our office in resolving your issue as fast as possible. All contact information is confidential. This institution is an equal opportunity provider.

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* 1. Store Name and Location

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* 2. On a scale of 1 to 5, with 1 being the worst and 5 being the best, how would you rate your interaction with store staff and/or cashier at this vendor location?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 3. Please list below any additional comments about your shopping experience at this vendor location. Please include all details such as names, dates, etc.

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* 4. If you feel as though you were discriminated against while at this vendor location, please leave a comment here describing what happened. You can also click here to file a program discrimination complaint.

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