Search

ABOUT US
SERVICES
PATIENTS
GIVING
CAREERS
COVID-19
- COVID-19 Care
- COVID-19 Behavioral Health Resources
Donate Now

ABOUT US
SERVICES
PATIENTS
GIVING
CAREERS
COVID-19
- COVID-19 Care
- COVID-19 Behavioral Health Resources
DONATE NOW

FOLLOW MY HEALTH LOGIN
CONTACT US
DIRECTIONS

home / Services / Wic application and forms

Interested in Learning or Applying to WIC?

WIC Forms

REFERRAL FORMS

Consent to Release Information
Prenatal
Postpartum
Pediatric

Please fill out this application:

First Name (required)

Last Name (required)

Street Address (required)

City (required)

ZIP (required)

Email (required)

Phone

When is a good time to call you?

How did you hear about WIC?

Have you ever been to WIC? If yes, how long ago?

Language Preference

Is it OK to text you about WIC?
Yes

LOG IN: FollowMyHealth

HEALTH CENTER LOCATIONS

LAKE FOREST
22481 Aspan St., Suite A
Lake Forest, CA 92630

SAN CLEMENTE
1300 Avenida Vista Hermosa, Suite 250
San Clemente, CA 92673

SAN JUAN CAPISTRANO
30300 Camino Capistrano
1st floor/Medical
2nd floor Admin/Dental/WIC
San Juan Capistrano, CA 92675

APPOINTMENTS

Medical: (949) 240-2272
Behavioral Health: (949) 240-2272
Dental: (949) 488-7682
WIC: (949) 488-7688

MEDICAL RECORDS
FAX: (949) 240-5869
FAX: (949) 488-7698 (WIC and Dental)

AFTER-HOURS NURSE ADVICE LINE
(949) 240-2272

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.

ADMINISTRATION

PHONE: (949) 240-2030

CAREER OPPORTUNITIES

BOARD PORTAL

© 2022 Camino Health Center

English | Español