Apply for Certification

Submit your application

Submitting an application is the second step of the certification process. Interested institutions must complete a gap analysis and be invited to apply. Applications should be submitted as a single pdf document, including a cover letter and appendix materials.

Hospital Lead Contact
Prefix First Last
Your Title
Your Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Phone Number
Your E-Mail Address
Additional comments
Files
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Accepted file types: pdf, Max. file size: 64 MB.
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Submit your application

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