Hospital Certification Application
Certification applications are closed December 1, 2022 – January 4, 2023.
Recertifying hospitals due in December received individual notifications with instructions via email. Annual Reports submissions remain open. New application manager platform launches January 4, 2023.
Please review the following considerations prior to beginning
the online application.
- The application must be submitted in one session. If you are unable to do this, consider copying the fields required into a separate word document that can be completed and edited prior to the final online submission.
- Use a suggested web browser. Be sure you are completing the form using one of the following web browsers: Google Chrome, Firefox, or Safari
- Check your hospital firewall. If you find your hospital firewall may prevent you from uploading documents to submit electronically, please complete the fields required and email the documents separately to email@example.com
- Check for a confirmation message upon submission. If after pressing “Submit,” the “Thank you! Your Hospital Application has been submitted.” text box does not appear, please scroll up through the form to ensure all fields have been properly completed.
*System-level applicants, please email firstname.lastname@example.org to schedule a phone call prior to submission.
* Indicates Required Field
(If you are upgrading to a higher level, please fill out the Renewal Application Form here.)