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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

Las Raices Latinas: The Roots of Our Community Gala
more info

April 4
6pm-9pm

Denver Marriot City Center
1701 California St.
Denver, CO. 80202
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Colorado Rural Health Center Conference
more info

April 8-10

Sheraton Denver West Hotel
360 Union Blvd
Lakewood, CO 80228
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26th Annual Colorado Child and Adolescent Mental Health Conference
more info

April 13-14
8:30am-4pm

Hilton Fort Collins
425 W Prospect Rd
Fort Collins, CO 80526
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