Pediatric ReadinessFacility RecognitionApplication Forms PCCC/EDAP Renewal Application
PCCC/EDAP Renewal Application
This application packet for PCCC/EDAP renewal is available below in a PDF format. In addition, there are forms within the application packet that need to be completed. These forms are available below in the section titled Fillable Word documents.
PDF format (Contains the complete application packet)
- PCCC/EDAP Facility Recognition Renewal Application Packet Must be viewed with Adobe Acrobat Reader. Please click here to download a free viewer from Adobe.
Fillable Word documents (these need to be completed and included in the renewal application)
- Request for Re-Recognition of Pediatric Critical Care Center (PCCC) and Emergency Department Approved for Pediatrics (EDAP)
- Pediatric Critical Care Center Plan Checklist
- Credentialing Forms for Emergency Department, PICU and Pediatric Unit Physicians/ED Nurse Practitioners, Physician Assistants, and Nursing Staff
- EDAP Equipment/Supply/Medication Checklist
- PCCC Equipment/Supply/Medication Checklist
- Hospital Pediatric Preparedness Checklist