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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

Give My Regards to Broadway - Wheat Ridge Active Adult Center
more info

Jan 15
12:30pm-2:30pm

6363 W 35th Ave.
Wheat Ridge, CO. 80033
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Dusty Saunders Book Signing - Wheat Ridge Active Adult Center

Jan29
2pm-4pm

6363 W 35th Ave.
Wheat Ridge, CO. 80033
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Castle Rock Chamber of Commerce Healthy Living Expo

Feb7
8am-3pm

500 Fairgrounds Rd
Castle Rock, Colorado 80104
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Speak Up for Kids - more info

March 18
7:30am-2:30pm

Denver Art Museum and the Colorado State Capitol

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