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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

Greens Fore Giving-Rotary Club of Fort Collins

June 18
10am-1pm

Collindale Golf Course
1441 East Horsetooth Road
Fort Collins, CO 80525
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Pride Fest

June 20-21

Civic Center Park
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Greeley Stampede
more info

June 25
to
July 5

Island Grove Regional Park
600 N 14th Ave
Greeley, CO 80632
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