Colorado WIC UPC Request Form
If you believe you found a WIC allowed item that is not on the approved list or that you were not able to buy with your eWIC card, you can request a review of the item by completing the form below. Please provide information about the item, your WIC grocery store and upload a picture of the items label and barcode if available.
Contact Information
Colorado WIC may want to contact you with questions about your request
Your Name
Phone Number
Email
Store Information
Grocery stores must be WIC authorized for item request to be considered
Store Name
Street Address
City
State
Zip Code
Enter product information below:
All products must meet current Colorado WIC Standards
Food Item
*
Please Select
Bread/Whole Grain
Cereal
Cheese or Tofu
Eggs
Fish
Fruit or Vegetable
Infant Formula
Infant Cereal, Fruits and Vegetables, Meat, etc
Juice
Legumes
Milk
Yogurt
Other
UPC/Barcode
*
(UPC-A: 12 digits below barcode, no spaces)
Brand Name
(Kellogg's, Campbell's, Market Pantry, etc)
Food Name
*
(Cheddar Cheese, Skim Milk, Black Beans, etc)
Package Size
(16-oz, 1 pound, 1 gallon, etc)
Comments
Upload a Photo
If available, upload a photo of the front and back of the food label and the barcode by clicking the button below.
Upload a Photo or File
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