Ohio Department of Health WIC Program Application 2026

1. Click ‘Get Form’ to open the Ohio Department of Health WIC Program Application in our editor.
2. Begin by filling out Section A with your name, address, and contact information. Ensure accuracy as this information is crucial for communication.
3. In Section B, list all individuals living in your home. For each person, provide their full name and indicate their ethnicity by checking the appropriate boxes.
4. Continue to detail any pregnancies or breastfeeding situations in Section C. Be sure to include dates of birth and due dates where applicable.
5. Section D requires you to check if anyone in your household receives assistance from programs like Medicaid or Food Assistance. Provide names as needed.
6. In the income section, list all sources of income for each household member. Include gross amounts and how often they are received.
7. Finally, ensure you sign the application at the back, affirming that all information provided is true and complete.

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