Apply Online

You can fill out the application form and submit it through this website. After we get your form, we’ll send you a letter asking for proof of:

  1. Your identity
  2. How much money you get
  3. How much you pay for things like child care and child support
  4. Your citizenship or immigration status

Apply Now. This form is also available en Español.

This online application works on desktop computers, but not mobile phones or tablets. If you are using one of these devices, please download the form [en Español], fill it out by hand, and mail it or fax it to us.

Other Ways to Apply

You can download the form [en Español], fill it out by hand, and mail it or fax it to us.

You also can apply at a clinic that offers Texas Women’s Health Program services. Fill out the form at the clinic and you might get services the same day. After we get your form, we’ll send you a letter asking for proof of the items listed above.

Pick up an application form at a Women, Infants and Children (WIC) Nutrition Program office. Call 1-800-942-3678 (toll-free) to find an office.

Call the Texas Women’s Health Program at 1-866-993-9972 (toll-free). We can take your call from 8 a.m. to 6 p.m. Central Time.

Examples of Proof We Need

  • Paycheck stub or copy of a check from the last 60 days.
  • Forms that show that someone in your family is in a benefits program:
    • Your Texas Benefits Medicaid ID card for one of your children.
    • WIC verification of certification (this shows you are in the WIC program).
    • WIC voucher.
    • WIC / Lone Star Card shopping list.
  • A letter from an employer.
  • Court papers that show you get child support.
  • Unemployment benefit award letter or pay stubs.
  • Supplemental Security Income award letter or pay stubs.
  • Receipts or income tax returns that show what you pay for day care costs.
  • Court papers, canceled checks, wage withholding statements that show how much you pay for child support.
  • A U.S. passport.
  • A certificate of naturalization.
  • A certificate of U.S. citizenship.

The 3 items prove both citizenship and identity. If you don’t have one of these documents, you will need to show 2 documents, one from each list below:

Proof of citizenship Proof of identity
U.S. birth certificate Current driver's license with photo
U.S. citizen ID card DPS ID card with photo (for example: Texas ID card)
Hospital record of birth Work or school ID card with photo
Northern Mariana ID card  
American Indian card with classification code KIC  
Religious record of birth with date and place of birth, such as baptism record  
Affidavit from 2 adults establishing the date and place of birth in the United States  

An example of an item that shows proof of immigration status is an alien registration card or document from the Bureau for Citizenship and Immigration Services (formerly INS).

You have to prove citizenship, immigration, and identity only one time. You don’t need to send these items again if you reapply.

Our Mailing Address and Fax Number

Texas Women's Health Program
P.O. Box 149021
Austin, TX 78714-9021

Fax (toll-free)- 1-866-993-9971

Submit a Texas Women’s Health Program application here or call us at 1-866-993-9972.

Apply Now

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