Welcome to the State of California 

 

 

Office of State Publishing (OSP) Order Forms

For California Local WIC Agencies ONLY

NOTE: If you did not receive the automatic email response "Your WIC order has been received", please read the updated Instructions (PDF)"Opens a new browser window". You may need to resubmit your order using another method.

  • 513 Prenatal, Postpartum, and Breastfeeding Materials (PDF)"Opens a new browser window"
  • 514 General Nutrition and Health Information (PDF)"Opens a new browser window"
  • 515 Orientation Materials (PDF)"Opens a new browser window"
  • 516 Infant Materials (PDF)"Opens a new browser window"
  • 517 Children Materials (PDF)"Opens a new browser window"
  • 518 Outreach Materials (PDF)"Opens a new browser window"
  • 519 Food Package Materials (PDF)"Opens a new browser window"
  • 520 Clearinghouse Materials (PDF)"Opens a new browser window"
  • 522 Campaigns (PDF)"Opens a new browser window"
  • 524 Administrative Materials (PDF)"Opens a new browser window"
  • 526 Local Vendor Liason (LVL) Materials (PDF)"Opens a new browser window"
  • 527 Magazines (PDF)"Opens a new browser window"
  • Note:  WIC Vendor Materials Form - OSP 508 has been moved to Grocer Vendor Resources.

     

    California Department of Public Health (CDPH) Forms

  • CDPH 4007 Vendor Report Concerning WIC Participants (PDF) "Opens a new browser window"
  • CDPH 4125 Report Concerning Vendors for Local Agency and Participant Use (PDF) "Opens a new browser window"
  • CDPH 4134 Notice of Action Affecting WIC Program Applicants (PDF, English)"Opens a new browser window"| Spanish 
  • CDPH 4143 Infant Screening and Medical Justification for Therapeutic Formulas (PDF)"Opens a new browser window"
  • CDPH 4144 Child Screening and Medical Justification for Therapeutic Formula (PDF)"Opens a new browser window"
  • CDPH 4145 Lost or Stolen Checkstock Report (PDF) "Opens a new browser window" 
  • CDPH 4304 Notice of Action Affecting WIC Program Participation (PDF) "Opens a new browser window"| Spanish 
  • CDPH 4476 Participant Abuse Report (PDF)"Opens a new browser window"
  • CDPH 247A Referral for Infant and Child, Half Sheet (PDF)"Opens a new browser window"Full Sheet (PDF)"Opens a new browser window" Instructions (PowerPoint, 5.3 MB) 
  • PM 247 1 Referral for Pregnant Woman (PDF)"Opens a new browser window"
  • PM 247 2 Referral for Postpartum/Breastfeeding Woman (PDF)"Opens a new browser window"
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    Nutrition Questionnaires

  • CDPH 4153 Postpartum Woman (PDF, 47.3 MB, English/Spanish)"Opens a new browser window"Arabic | Armenian | Chinese | Hmong | Russian | Vietnamese
  • CDPH 4154 Pregnant Woman (PDF, 9.7 MB, English/Spanish) "Opens a new browser window"
  • CDPH 4159 Infant Birth-3 Months  (PDF, English/Spanish)"Opens a new browser window"
  • CDPH 4160 Infant 4-11 Months (PDF, English/Spanish)"Opens a new browser window"...Armenian | Chinese | Hmong | Russian | Vietnamese 
  • CDPH 4161 Child 1-4 Years (PDF, English/Spanish)"Opens a new browser window"
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    Last modified on: 9/12/2014 11:27 AM