---
title: CPEN Application Form Template - Certified Pediatric Emergency Nurse | Paperform
description: Professional CPEN certification application form template for pediatric emergency nurses. Collect experience verification, PALS certification, exam registration, and application fees in one streamlined form.
url: "https://paperform.co/templates/certified-pediatric-emergency-nurse-cpen-application"
type: static
generatedAt: "2026-03-28T00:43:16.921Z"
---

[← Back to free form templates](/templates/)    ![Certified Pediatric Emergency Nurse (CPEN) Application](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/certified-pediatric-emergency-nurse-cpen-application.png)
    [Preview](https://_preview.paperform.co/ai-template/certified-pediatric-emergency-nurse-cpen-application) [Use this template for free](/create?ai-template=certified-pediatric-emergency-nurse-cpen-application)    [Application Forms](/templates/category/applications/) [Healthcare](/templates/industry/healthcare/)[Education](/templates/industry/education/) [Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
### Advance Your Pediatric Emergency Nursing Career with CPEN Certification

The **Certified Pediatric Emergency Nurse (CPEN)** credential is the gold standard for nurses specializing in pediatric emergency care. This certification demonstrates your expertise in assessing, triaging, and providing emergency care to infants, children, and adolescents. Our streamlined CPEN application form helps you organize your qualifications, document your pediatric ED experience, and register for the certification exam—all in one place.

#### Why Choose Paperform for Your CPEN Application?

Whether you're a certification board, healthcare institution, or professional association managing CPEN applications, Paperform makes the entire process efficient and professional. Instead of juggling PDFs, emails, and spreadsheets, you get a **branded, mobile-friendly application form** that captures everything you need: clinical experience hours, PALS certification details, educational background, and exam preferences.

**For certification bodies and healthcare organizations**, Paperform's conditional logic ensures applicants only see questions relevant to their pathway. If a nurse needs additional documentation or doesn't meet prerequisite hours, the form automatically adjusts. You can collect application fees via integrated payment processing with Stripe, PayPal, or Square, and use **Papersign** to gather required attestations and authorization signatures electronically—keeping your entire application process digital and audit-ready.

**For individual nurses applying for certification**, this template provides a clear, step-by-step application experience that saves you time. Upload your PALS certificate, document your pediatric emergency department hours, select your exam date and location preferences, and pay your application fee—all without switching between multiple platforms.

#### Key Features That Support CPEN Application Management

 - **Conditional Logic:** Show or hide questions based on applicant responses (e.g., additional documentation requirements for nurses with less than 2 years of pediatric ED experience)
 - **File Uploads:** Securely collect PALS certificates, nursing licenses, transcripts, and supporting documentation
 - **Payment Integration:** Process application fees, exam fees, and late registration charges directly within the form
 - **Calculation Fields:** Automatically calculate total clinical hours, verify minimum requirements, and compute applicable fees
 - **Email Notifications:** Automatically send confirmation emails to applicants with next steps and exam preparation resources
 - **CRM Integration:** Sync applications directly to your database or certification management system via Stepper, connecting to platforms like Salesforce, HubSpot, or Airtable

#### Streamline Your Workflow with Stepper Automation

Once applications are submitted, **Stepper** (stepper.io) can automate your entire review and approval workflow. Route applications to review committees, trigger background checks, send conditional approval emails, schedule exam slots, and update certification databases—all without manual data entry. For certification boards processing hundreds of applications, this level of automation transforms a weeks-long process into days.

#### Industry Trust and Compliance

Paperform is **SOC 2 Type II compliant and GDPR-ready**, ensuring applicant data is handled with the highest security standards. With built-in encryption, role-based access controls, and detailed audit logs, you maintain complete oversight of sensitive healthcare credentials and personal information.

#### Perfect for Healthcare Certification Programs

This template isn't just for CPEN—it's adaptable for any specialty nursing certification (CEN, CCRN, TCRN, SANE), allied health credentials, or professional certification programs requiring experience verification, prerequisite documentation, and exam registration. Over 500,000 teams worldwide trust Paperform to handle their professional applications with the flexibility to customize every detail without writing a single line of code.

Whether you're a nurse advancing your career in pediatric emergency medicine or an organization managing certification applications, Paperform gives you the tools to make the process smooth, professional, and efficient. Get started with our CPEN application template today and experience the difference a purpose-built form platform makes.
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