Maine WIC wants you to have a positive shopping experience. We appreciate you sharing your issues with us.

About You:

Name*

Email*

Phone

Zip Code

Card Number (last 4 digits)*

Store Name (or NA if not applicable)*

Store number or location (or NA if not applicable)*

Date of issue (required**)

Time of issue

About Your Experience

A PIN issueA great shopping experienceI can’t buy specific product(s) with WIC (attach pictures of product and receipts)I can't buy anything with WIC (attach pictures of product, receipts, PIN pad if relevant)Cashier issueOther experience or idea to improve

Description of issue or idea:

PHOTOS (Product, receipts, PIN pad message, etc.)

Please take pictures of the items you could not purchase, receipts, or PIN pad messages (if applicable), then include them here by pressing the 'Choose File' Button. Please upload only one image per 'Choose File' button.

Please leave this field empty.