CR: 2 Rights and Responsibilities of an Applicant/Participant

Effective Date: 12/00 Downloads: PDF Version    Revised Date: 07/15


Clinic staff will, at the time of each certification, have the participant or parent/caretaker of the participant read, or be read to, the rights and responsibilities of a participant in the WIC Program.


At each certification, the participant or parent/caretaker of the participant will sign and receive a copy of the “Nevada State WIC Rights and Responsibilities” attesting to the fact that s/he has been informed of this information. The “Rights and Responsibilities” form will be maintained in the participant’s record.


To facilitate use of health services and increase nutrition education provided, the participant or parent/guardian should be encouraged to attend scheduled appointments. At the time of certification, sponsors may select up to two proxies who may serve as people authorized to attend WIC appointments if needed. A proxy is usually a caregiver that has knowledge of the infants/child’s eating habits and medical conditions (i.e. grandparents, father, or mother). Proxies serve as temporary substitutes in the event that the sponsor has a hardship and is unable to attend the scheduled appointment of a minor WIC participants only (i.e. a pregnant woman must attend her own WIC appointments and may not designate a proxy to attend as a substitute). Use of an alternate/proxy should not be routine and may not be used for a certification or re-certification except:

  • Individuals receiving ongoing healthcare and unable to visit the local agency in person
  • Working parent / caregivers


  1. Proxies may be designated by participants/parent or guardian at the time of certification and shall be reviewed at each certification. Proxies must be identified on the Rights and Responsibilities Form and must present proof of identity at each clinic encounter. Sponsors have the right to update their proxy designees at any time.
  2. Designated proxies have the same level of responsibility as the participants/parent or guardian and will be held to the same standards of conduct. Refer to CR: 10 – Participant Violations and Sanctions (Definition of Program Violations & Reporting and Documentation of Program Abuse or Dual Participation) for additional guidance.
  3. The participant/parent or guardian shall be informed of the right to a proxy and of the proxy responsibilities during the certification visit.
  4. If a participant sends a note authorizing a proxy, verify the participant or sponsor’s signature from the Rights and Responsibilities form in the file.

The following sentences will be read by, or read to, the participant or parent/caretaker of the participant at each certification:

Participant Rights

  • WIC Staff will treat you with courtesy and respect. Everyone will be treated equally.
  • If you disagree with a decision about your WIC eligibility you may appeal by requesting a Fair Hearing.
  • WIC will provide you information about nutrition, breastfeeding, and healthy foods.
  • WIC will help you in getting other services, such as Immunizations, Supplemental Nutrition Assistance Program (SNAP), Medicaid, and Voter Registration.

Participant Responsibilities

  • To keep your appointments and be on time. If you cannot keep your appointment, call your local WIC office to reschedule as soon as possible.
  • I may be taken off the WIC Program if I miss appointments for two consecutive months.
  • To bring all documentation requested to each appointment.
  • To treat WIC and store staff with courtesy and respect.
  • To participate in only one WIC clinic at a time. If I move, I can ask for a transfer card.
  • Choose WIC or CSFP (Commodity Supplemental Food Program) to participate in. A person cannot be on both programs at the same time.
  • Follow the rules when using WIC benefits. WIC staff will tell me how to redeem my benefits when I am put on the program.
  • To buy only the foods listed on my WIC benefits. I will use the foods only for the person on the program.
  • For food benefits received. I understand that if my food benefits are lost or stolen, they may not be replaced.
  • To report any changes in my income, family size, or eligibility for Medicaid, SNAP, or TANF.

Participants will also be told of program violations that can result in (1) the participant being taken off WIC for up to one year, (2) the possibility of legal charges, and/or (3) repayment of funds.

  • You do not tell the truth about all the information you give to WIC
  • You get benefits from more than one clinic at a time
  • You/child participate in CSFP and WIC at the same time
  • You do not follow the rules when using your food benefits.
  • You use abusive language with clinic staff, store clerks, or managers
  • You are physically violent with clinic staff, other WIC clients, or store personnel.
  • You trade or sell WIC foods including formula for cash.