CHCPCA Application

CHCPCA Application

Home / Resource Center / CHCPCA Application

Document Access

The Colorado Health Care Professional Credentials Application (CHCPCA) became effective for initial credentialing in Colorado January 1, 2006. Effective May 1, 2006, the Colorado Department of Public Health and Environment announced that the same form shall be effective for re-credentialing in Colorado as well. This application, when completed, should be provided/forwarded to the appropriate credentialing entity upon request.

If you are a COPIC insured, please select the first option to edit and save your CHCPCA Application for future use. If you are not insured by COPIC, you can download and edit either the Adobe *.pdf or the Microsoft Word *.doc versions

Learn More About COPIC Coverage

Get a Free Quote