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Acceptable Documentation
Authorization
Medical Documentation
Medical Referral for Children
Medical Referral for Women
WIC Clinic Schedule

  

Farmers Market
 
2012 WIC Health Fair
August 7, 2012
Island Park - Wellsville
Click on the link for more details!

Located at 3453B Route 417E, Wellsville.

WIC is a Federally Funded program that serves pregnant, breastfeeding
and postpartum women, infants and children up to age five.

WIC provides the following to families residing in Allegany County:

Nutrition Education
Breast Feeding Education & Supplies
Monitor Pregnancy, Infant and Child Development
Provide Food Package Coupons
Work Cooperatively with Physicians and Other Agencies

To make an appointment, please call 1-800-394-1942.

 

Eligibility Requirements
*Budget Sheet or Benefit Card from the Department of Social Services
(If a child is certifying, benefit card must be in the child’s name)
Or Income Guidelines equaling or less than the following
Guidelines include gross family income as well as the following funds:
 

FAMILY SIZE

ANNUAL

MONTHLY

TWICE-MONTHLY

BI-WEEKLY

WEEKLY

1

20,665

1,723

862

795

398

2

27,991

2,333

1,167

1,077

539

3

35,317

2,944

1,472

1,359

680

4

42,643

3,554

1,777

1,641

821

5

49,969

4,165

2,083

1,922

961

6

57,295

4,775

2,388

2,204

1,102

7

64,621

5,386

2,693

2,486

1,243

8

71,947

5,996

2,998

2,768

1,384

FOR EACH ADDITIONAL FAMILY MEMBER ADD:

+7,326

611

306

282

141

* One month of current pay stubs for each employed household member

*Verification of unemployment (check stub)

*Verification of disability (Disability award letter/ check)

*Verification of Compensation (Compensation letter /check)

*Letter from court regarding child support/alimony

*Social Security Income award letter/ check

*Self-employed income records (bring last year’s income tax form or quarterly estimated report)

*Verification of lump sum reimbursements (award letter)

*Proof of any other income into your household (rental income, income from estates/trusts, interest/dividends, etc.

*Any other cash received or withdrawn from any source (bank statements or bank book)

 

Child’s birth certificate, immunization records and proof of New York State residency required for all applicants.

Appointments available at the following off-site clinics: 

Alfred Station Angelica  Bolivar Belfast
Canaseraga Cuba  Fillmore Friendship
Wellsville      

 

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