Please ensure Javascript is enabled for purposes of website accessibility

Attestation for Supervision of Unlicensed Professionals and/or Pre-licensed Clinicians

Form

Medicaid
Provider

In accordance with the Colorado Medicaid Standards for Supervision of Unlicensed Professionals policy, providers with licensed clinicians intending to supervise unlicensed professionals and/or pre-licensed clinicians that fall under the guidelines of this policy must submit this attestation to each contracted Regional Accountable Entity (RAE) to engage in supervision practices outlined by this policy.