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Apply for SCOPE Certification

Application for SCOPE Certification

                                                                                                                                     Download Application Here

The Application Process

In order to participate in SCOPE, offices must complete an application that collects information on characteristics of the office, providers, and specific safety measures and processes within the office. There are elements that are considered critical, and a minimum of 80% of these critical elements must be met by a office before a site review is conducted. An office must have in place 60% of the remaining safety processes to be fully certified. The application will be reviewed and followed with a site visit if these are met to review the application information in more detail and observe the processes as well as a drill or simulation.

The questions in the Application refer to patient safety elements. Some of these patient safety elements are so basic that the office must demonstrate compliance with the “critical element” (as noted in the Application) in order to obtain certification. In addition to the required elements, the answers to the questions about the other patient safety elements will be used to score the application. A site visit will not be scheduled until the application is complete and all required supporting documents are submitted.

The application can be completed electronically, and the required supporting documents can be scanned and submitted electronically. You can complete the application across several days. Simply click "SAVE" at the bottom of the page before logging off. You can return to the application and continue working by logging back in later. The application can also be printed, completed by hand, and mailed in. Please do not send any patient health information and/or documents that do not have all patient identifiers completely removed. In addition for peer review documentation, such as peer review meetings, please assure that all provider and patient specific information is de-identified. If you are unsure whether the information that you are sending us contains patient health information, please contact us.

Supporting documentation that can be submitted with the application include office policies and procedures, employee manuals, training materials, office meeting schedules and minutes, personnel records, certification cards, patient handouts and educational materials.

The application has six sections that all offices must answer:

  • Office Management and Administration;
  • Documentation and Reporting;
  • Medication Safety;
  • Office-Based Surgical Procedures;
  • Equipment;
  • Quality Improvement and Measurement

The seventh section is the “Practice Module” section for which each office should select two modules to complete.