Thank you for your interest in the Louisiana WIC Program.

Did you know that Louisiana WIC now uses the WIC-EBT card which is much easier than paper vouchers?  We have just a few questions to ask to screen you for the residency, income and other requirements of the program.  Before you can receive a WIC-EBT card in person, you will need to bring your and your children's ID, proof of income/Medicaid/SNAP card to the WIC office or upload them into the WIC Gateway, which is like a patient portal.  Completing this pre-screening survey is completely voluntary and is not required to receive WIC services.  

If you know what clinic you want to attend, it may help clinic staff call you back sooner.  You can pull up a regional map to find locations near you on this link: https://louisianawic.org/find/ 

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* 1. Louisiana WIC is for residents of Louisiana.  Check the box below that describes you and your family.

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* 2. Louisiana WIC is for pregnant women, women who have had a baby in the last 6 months, breastfeeding women, infants, children up to 5 years old and foster infants and children up to 5 years old.  Who in your household do you want to sign up for WIC:

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* 3. Please provide the name of one of the women, infants or children living in your house who you would like to receive WIC.

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* 4. Please provide their date of birth.

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* 5. How many people live in your household?  Count all children, including the unborn child of any pregnant women living in your household?

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* 6. How many people in your household receive income?  Income comes in different forms including paychecks from an employer (whether cash, check or direct deposit), social security, disability payments, child support and unemployment benefits.

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* 7. Do you or anyone in your household currently receive Louisiana Medicaid, Louisiana SNAP (food stamps) or TANF?

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