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State Plan Checklist - CERTIFICATION, ELIGIBILITY & COORDINATION OF SERVICES 8/14/2026 Page 24

c. Methods used by other health and social service programs to refer clients to the WIC Program include (check all that apply, and indicate whether the method selected is the primary method of referral):

Primary WIC Program referral form Health/social program referral form Telephone call X Verbal referral X Automated client/participant information exchange