Apply for Privileges

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Dayton Children's Hospital's professional staff credentialing process requires approval of a pre-application. You can now complete a pre-application on line and attach it to an email for consideration. Download the Application Here (Adobe Acrobat Reader Required)


  1. View the pre-application in the Adobe Acrobat Reader.
  2. Fill in all of the fields.
  3. Save the filled in form to your local computer and name it preapp.pdf
    1. Click the little floppy diskette in the upper left corner of the Acrobat viewing window.
    2. Type preapp.
    3. Click Save.
  4. Click the email link above to open your email program.
  5. Find where to attach a file to an email within your email program and then locate where you saved the form you filled out. On a MS Windows 9x or NT machine it's probably in your 'My Documents' folder.
  6. E-mail the professional staff office.


Online referral form

Did you know you can make a referral to any of our specialty clinics online? Use the form below to submit directly to central scheduling. 

Complete the form 

Pediatric Link

Finding the latest trusted child health and safety information doesn't have to be hard. Pediatric Link, Dayton Children's e-newsletter offers timely and up-to-date information for health care professionals from the experts you trust at Dayton Children's.

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The Children's Medical Center of Dayton Dayton Children's
The Right Care for the Right Reasons

One Children's Plaza - Dayton, Ohio - 45404-1815