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 .

In The Community

Our Members Matter


Our Members Matter

Upcoming Events

November 12

CART (Community Accessing Resources Together)  A free health care event that will help Coloradoans get connected for health care, nutrition education, food assistance sites, dental care and mental care services. COA has partnered up with CART and we will be hosting a table offering assistance with enrollment for CHP+ and Medicaid.

Click here for more information

November 17

Project Homeless Connect 15 (PHC15) PHC is a one day, free event where individuals and families experiencing homelessness can access services and resources including medical care, Homeless Court, benefit assistance, employment services, haircuts, clothing and other community resources.




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