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The State of Colorado has mandated the use of this credentialing application beginning December 31, 2005 (C.R.S. § 25-1-108.7).

Colorado Access will notify you regarding the submission of your application. For your convenience, you do not need to submit your application until requested to do so by the Credentialing Staff.

Microsoft Word format

Click here to download the MSWord version of the CHCPCA Save the document to your computer, then either fill it out in MSWord or print it out and complete it by hand.

PDF format (1.67 MB file)

Click here to download the PDF version of the CHCPCA. If you have Adobe Acrobat Standard, you may save the document to your computer, then fill it out and save it. If you only have Adobe Acrobat Reader, you may fill it out and print it without saving, or print it and complete it by hand.

Questions regarding this application should be directed to .

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Upcoming Events

Weld Project Connect
Neighbors Helping Neighbors more info

Oct17
12pm-4:30pm

Island Grove Regional Park Events Center
North 14th Avenue and D Street
Greeley, CO
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Medicare Member Meeting

Oct 21
1pm-2pm

Allen Gardens
3030 Richard Allen Ct.
Denver, CO. 80205
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Successful Aging Expo

Nov 1
9am-4pm

Hotel Elegante Conference and Event Center
2886 S Circle Dr.
Colorado Springs, CO 80906
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