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)
- View the pre-application in the Adobe Acrobat Reader.
- Fill in all of the fields.
- Save the filled in form to your local computer and name it preapp.pdf
- Click the little floppy diskette in the upper left corner of the Acrobat viewing window.
- Type preapp.
- Click Save.
- Click the email link above to open your email program.
- 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.
- E-mail the professional staff office.
Make a referral
Fax referral forms: 937-641-4500, 24 hours
Toll-free fax: 1-866-891-6941
Hours: 7:30 am to 7:00 pm, Monday through Friday
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