This form is for Women, Infants, and Children (WIC) participants in Dane County, Wisconsin. To report a problem using your WIC benefits to buy eligible items, please use this form or email wic@publichealthmdc.com. Our staff will contact you to discuss the problem further.

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Contact Information
Problem Information
Attachments
You can attach pictures of the items and your receipt. Please make sure the items barcode is visible. Allowed file types: jpg, jpeg, png, pdf, doc, docs, xls, and xlsx. Maximum file size: 10 MB.
More information
  • Files must be less than 10 MB.
  • Allowed file types: jpg jpeg png pdf doc docx xls xlsx.
More information
  • Files must be less than 10 MB.
  • Allowed file types: jpg jpeg png pdf doc docx xls xlsx.
More information
  • Files must be less than 10 MB.
  • Allowed file types: jpg jpeg png pdf doc docx xls xlsx.