You may use this page to submit a reference, at the request of a CPE applicant. Your reference may be sent via e-mail
simply by clicking the SUBMIT button at the bottom of the page, or you may print the page and send it via US mail to:
Chaplain Betty White, Clinical Pastoral Care Coordinator, Department of Pastoral Care, HUP Dulles One, 3400 Spruce Street, Philadelphia PA 19104.
(Note that an e-mail submission is not electronically secure, if you have confidentiality concerns.)
You should PRINT A HARD COPY FOR YOUR RECORDS. If you have questions about this form or procedure,
call Chaplain White at 215-615-0988.