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b. The referral methods used by local agencies to other health and social service programs include (check all that apply, and indicate whether the method selected is the primary method of referral):

Primary ☒ State agency-developed referral forms ☒ ☒ Local agency-developed referral form ☐ ☒Telephone call to referring agency ☐ ☒ Verbal referral to participants ☐ ☐ Automated client/participant information exchange ☐ ☒ Written literature on referral programs ☐ ☒ Follow-ups by staff to monitor ☐ ☒ Maintain a list of local resources for drug and other harmful substance abuse ☐ ☐Counseling ☐ ☐ Other (specify): Click or tap here to enter text. ☐

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

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☐ Health/social program referral form

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☒ Telephone call

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☒ Verbal referral

☒

☐ Automated client/participant information exchange

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☒ Written literature on the WIC Program

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☐ Other (specify): Click or tap here to enter text. d. The State agency has a system in place to monitor the extent to which WIC participants are using other health or social services (check all that apply): ☒ Yes (check): ☒ Medicaid ☒ TANF ☐ MCH ☒ SNAP ☐ Yes, other (specify): Click or tap here to enter text. ☐ No e. The State agency requires local agencies to monitor referrals to determine the extent of health or social services utilization in addition to State monitoring systems. ☐Yes ☒ No