When you participate in WIC, staff will ask you for some information. Some forms are required to participate. WIC staff will let you know if you need to fill out any of these forms.
Do you want to do your WIC appointment from home instead of coming into Adelante Healthcare?
Please contact us at 1.877.809.5092 for more information.
WIC Rights and Responsibilities
WIC Rights and Responsibilities Spanish
Statement of Documentation Spanish
Change of Authorized Rep Spanish
Language Access Waiver Spanish
Notice of Ineligibility Spanish
AZ Referral & physical presence Exemption Form
Note: All Forms require the free version of Adobe Reader for viewing and printing. Download a free copy of Adobe Reader here.
Click here to view forms in more languages.
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, disability, age, 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: How to File a Complaint, 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:
mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
fax: (202) 690-7442; or
email: program.intake@usda.gov
This institution is an equal opportunity provider.
COVID-19 Update: WIC is open for business. Adelante Healthcare WIC continues to offer phone appointments.
Adelante Buckeye
Open Mon-Fri 8am to 5pm
Closed for lunch 12pm-1pm
Adelante Healthcare Central Phoenix
Virtual and remote services available.
Adelante Gila Bend
Open Wed 8am to 4:30pm
Closed for lunch 12:30pm-1:00pm
Adelante Goodyear
Open Mon – Fri 8am to 5pm
Closed for lunch 12pm-1pm
Adelante Mesa
Open Mon – Sat 8am to 5pm
Closed for lunch 12pm-1pm
Adelante Peoria
Open Mon-Fri 8am to 5pm
Closed for lunch 12PM to 1PM
Adelante West Phx
Open Mon-Fri 8am to 5pm
Sat 8am to 4:30pm (By Appointment)
Closed for lunch 12PM to 1PM
Adelante Surprise
Open Mon-Fri 8am to 5pm
Sat 8am to 5:00pm (By Appointment)
Closed for lunch 12PM to 1PM
Adelante Wickenburg
Open Tues & Thurs 8am to 4pm
Closed for lunch 12-1pm
Luke Air Force Base WIC
7282 N. 137 Ave., Bldg. 1140
Glendale, AZ 85142
Ph: 1-877-809-5092
Fx: 623-583-3007
Military Pass Required
Open Mon 8am to 5pm
Closed for lunch 12-1pm
West Valley WIC
995 E. Riley Drive
Avondale AZ, 85323
Ph: 1-877-809-5092
Fx: 623-333-0271
Temporarily closed, until May 20th,2021
Peoria (South) Mobile WIC
8335 W. Jefferson St.
Peoria, AZ 85345
Ph: 623-236-4622
The City of Peoria Resource Center has temporarily closed, so clients will be seen at Adelante Peoria until it reopens.
To schedule an appointment, call 1-877-809-5092 ext.073826 or 623-236-4622
This health center receives HHS funding and has Federal PHS deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.