How to Apply

Call these numbers to set up an appointment with the WIC clinic nearest you:

Main Clinic: 633-2610

Amouli Clinic: 622-7534

Leone Clinic: 688-7434

Ofu Clinic: 655-1103

Tau Clinic: 677-3477; 3474

 

 

Eligibility

 

These criteria are:

  • Category – Pregnant, Breastfeeding, or Postpartum women, Infants, Children up to five years of age.
  • Residence – An applicant must live in American Samoa to be eligible for WIC in American Samoa.
  • Income – An applicant must be at or below 185% of the Federal Poverty Guidelines. This number is based on household size. (Table income guidelines are changed every year.)
  • Nutrition Risk – An applicant must have a medical/nutritional risk that can be improved by WIC nutritional services.

What to Bring to your Appointment:

  • Proof of income (paycheck, tax return, or letter from your employer)
  • Proof of residence or identity (driver’s license, utility bill, loan verification from local banks, or any other official identification)
  • Bring your baby or children who need WIC
  • Bring your baby’s or children’s immunization shot records or birth certificates

Client Services

Client Services: Client checks in with Clerk for appointment type and refer to service

  • Initial Certify
  • Re-Cert
  • High Risk
  • Document
  • Mid-Cert or Health Check
  • Nutrition Ed. or Breastfeeding

When service is complete, your next appointment will be scheduled.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at:http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

  1. mail: U.S. Department of Agriculture
    Office of the Assistant Secretary for Civil Rights
    1400 Independence Avenue, SW
    Washington, D.C. 20250-9410;
  2. fax: (202) 690-7442; or
  3. email: program.intake@usda.gov.

This institution is an equal opportunity provider.

© 2014 American Samoa Department of Human and Social Services