---
title: Certified Professional in Patient Safety (CPPS) Application Form | Paperform
description: Apply for CPPS certification with this comprehensive application form. Submit professional experience, quality improvement projects, safety culture assessments, and register for the patient safety exam.
url: "https://paperform.co/templates/certified-professional-in-patient-safety-cpps-application"
type: static
generatedAt: "2026-03-28T00:43:16.993Z"
---

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### Advance Your Career in Patient Safety with CPPS Certification

The **Certified Professional in Patient Safety (CPPS)** credential is the gold standard for healthcare professionals committed to reducing harm and improving patient outcomes. Whether you're a quality manager, risk specialist, nurse leader, or physician champion, CPPS certification demonstrates your expertise in patient safety principles, safety culture development, and evidence-based quality improvement.

This application form streamlines the entire CPPS certification process—from verifying your eligibility and professional experience to documenting your quality improvement projects and registering for the certification exam. By completing this comprehensive application, you're taking a significant step toward joining a global community of patient safety leaders.

#### What is the CPPS Certification?

The CPPS certification recognizes healthcare professionals who have demonstrated advanced knowledge and practical experience in patient safety. The credential validates your ability to:

 - **Lead safety culture transformation** within healthcare organizations
 - **Design and implement quality improvement initiatives** that measurably reduce patient harm
 - **Apply systems thinking** to identify and mitigate safety risks
 - **Drive organizational change** using evidence-based patient safety frameworks
 - **Analyze safety events** and translate findings into sustainable improvements

CPPS-certified professionals work across hospitals, ambulatory care settings, long-term care facilities, and health systems, serving in roles such as patient safety officers, quality directors, risk managers, clinical educators, and executive leaders.

#### Who Should Apply?

The CPPS certification is designed for experienced healthcare professionals who have demonstrated commitment to patient safety through their daily work. Typical applicants include:

 - **Patient Safety Officers and Coordinators** leading organization-wide safety initiatives
 - **Quality and Performance Improvement Managers** implementing evidence-based interventions
 - **Risk Managers** analyzing adverse events and developing prevention strategies
 - **Nurse Leaders and Clinical Managers** championing safety at the unit and system level
 - **Physicians and Advanced Practice Providers** driving clinical safety improvements
 - **Healthcare Administrators** responsible for safety culture and regulatory compliance
 - **Clinical Educators** teaching safety principles and tools to frontline staff

Candidates typically possess several years of professional healthcare experience with focused involvement in patient safety and quality improvement work.

#### How This Application Works

This application form guides you through each requirement for CPPS certification:

 1. **Professional Background:** Provide your current role, organization, and professional credentials. We'll verify your healthcare experience and educational background.
 1. **Patient Safety Experience:** Detail your direct involvement in patient safety activities, including the scope of your responsibilities and the populations you serve.
 1. **Quality Improvement Projects:** Describe up to three significant quality improvement or patient safety projects you've led or substantially contributed to. We're looking for initiatives that demonstrate your ability to identify safety gaps, implement evidence-based interventions, and measure outcomes.
 1. **Safety Culture Assessment:** Share your insights on current safety culture within your organization, your approach to assessing culture, and strategies you've used to drive cultural transformation.
 1. **Professional Development:** Document your commitment to ongoing learning through relevant training, conferences, workshops, and continuing education in patient safety and quality improvement.
 1. **Exam Registration:** Select your preferred exam date, testing location (or remote proctoring option), and any accommodations you may need.
 1. **References and Attestation:** Provide professional references who can speak to your patient safety work and attest to the accuracy of your application.

#### Preparing Your Application Materials

Before you begin, gather the following information:

 - **Resume or CV** highlighting your healthcare and patient safety experience
 - **Details of quality improvement projects** including specific interventions, metrics, and outcomes
 - **Professional reference contacts** (typically 2-3 colleagues, supervisors, or collaborators)
 - **Copies of relevant certifications** (nursing license, medical degree, quality certifications, etc.)
 - **Documentation of continuing education** in patient safety topics

Having these materials ready will help you complete the application efficiently and provide the comprehensive information needed for certification review.

#### Why Use Paperform for Your CPPS Application?

Managing professional certification applications requires careful attention to detail, secure data handling, and seamless workflow coordination. **Paperform** makes this process smoother for both applicants and certification bodies:

 - **Professional, branded application forms** that reflect the credibility of the CPPS credential
 - **Conditional logic** that adapts questions based on your background, showing only relevant sections
 - **Secure file uploads** for supporting documentation, transcripts, and project summaries
 - **Integrated payments** for application fees and exam registration through Stripe or PayPal
 - **Automated email confirmations** that acknowledge receipt and outline next steps
 - **GDPR and SOC 2 compliance** to protect sensitive professional and personal information

For certification administrators, **Paperform's Stepper integration** (stepper.io) can automate the entire post-submission workflow—routing applications to review committees, triggering credential verification checks, scheduling exam appointments, and updating applicant tracking systems without manual data entry.

#### The Path to Certification

Once you submit your application, here's what happens next:

 1. **Application Review:** A certification review committee evaluates your professional experience, quality improvement projects, and eligibility for the exam.
 1. **Eligibility Confirmation:** You'll receive notification of your eligibility status, typically within 2-4 weeks of submission.
 1. **Exam Preparation:** Access study materials, practice exams, and preparation resources to help you succeed on the CPPS examination.
 1. **Examination:** Complete the CPPS exam at your selected testing center or through remote proctoring. The exam covers patient safety principles, safety culture, quality improvement methods, systems thinking, and leadership.
 1. **Certification Award:** Upon passing the exam, you'll receive your official CPPS credential and can begin using the designation professionally.
 1. **Maintenance and Renewal:** Maintain your certification through continuing education and ongoing engagement in patient safety work.

#### Patient Safety is a Team Sport

Pursuing CPPS certification demonstrates your commitment to creating healthcare environments where patients receive safe, high-quality care every time. This credential equips you with the knowledge, skills, and professional network to lead meaningful change—from the bedside to the boardroom.

By joining the community of CPPS-certified professionals, you're contributing to a global movement to eliminate preventable harm, strengthen safety culture, and ensure that every patient benefits from evidence-based safety practices.

**Ready to advance your patient safety career?** Complete your CPPS application below and take the next step toward certification.

---

*The CPPS certification is offered by the Board of Certified Safety Professionals (BCSP) in collaboration with leading patient safety organizations. This application form can be customized for any professional certification program using Paperform's flexible platform.*
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