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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

Friends of Colorado Senior Center's Annual Fundraiser
more info

Aug 20
5pm-7pm

ProRodeo Hall of Fame
101 Pro Rodeo Dr
Colorado Springs, CO 80919
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Amazing Aging Expo
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Aug 29
8am-3pm

Denver Marriott Tech Center
4900 S Syracuse St
Denver, CO 80237
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Holly Hills Elementary Back to School Event

Sep 2
6:30pm-8pm

Holly Hills Elementary School
6161 E Cornell Ave
Denver, CO 80222
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