Medical Formula Order Form

Please note:
  • Check the Medical Formulas Available at Local Agencies list.
  • Per Federal Regulations, only one month of formula may be ordered at a time per participant.
  • Refer to Minnesota WIC Medical Formula Amounts Guide for formula-specific information.
  • Ensure formula order and packing slip match. Discrepancies must be reported within 24 hours.
  • If you have questions about the ordering process, email health.wic@state.mn.us or call 651-201-4404.
  • Other questions about formula, contact your State WIC Consultant.
  • Due to rapidly changing inventory levels, RUSH orders are unable to be honored.

Please review the availability of the following products before placing your order.


Status of some formulas are improving and the list below is updated to include limited availability or unavailable items only:

Amino Acid Based Formulas - Comparable Infant Formula
No known shortages at this time.

Amino Acid Based Formulas – Comparable Toddler Formula
Alfamino Jr. Vanilla (Nestle) - Not available
PurAmino Jr. all flavors & unflavored (Mead Johnson) – Not available
 
Hypoallergenic Formulas – Infant formula generally available in retail but can be ordered
Alimentum 12.1oz Powder (Abbott) –Not available
Pregestimil 16oz Powder (Mead Johnson) – Not available
Gerber Extensive HA 14.1 oz Powder (Nestle) - Limited availability, may be at stores
You can determine if the family has approval to utilize store brand Hypoallergenic in place of the above products.
 
Premature Based Formulas – generally available in retail but can be ordered
No known shortages at this time.
 
Misc items  
Pediasure Peptide 1.0 Strawberry (Abbott) – Not available
Nutramigen Toddler with Enflora LGG (powder and RTF) – Not available
Similac PM 60/40 14.1oz Powder (Abbott) – Not available
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