CHCPCA Application

CHCPCA Application

Home / Resource Center / CHCPCA Application

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.


Effective Janurary 1, 2020 COPIC will no longer host a completed copy of your Colorado Health Care Professionals Credentialing Application (CHCPCA) on our website. If you have previously saved your completed application within the Service Center on our website, we encourage you to login and download a copy of your application to your computer prior to 1/1/2020. The platform that the application is currently stored on will not be supported after 12/31/2019 and we will be unable to provide access to your application. We will also be unable to retrieve a copy for you after 12/31/2019. If you have any problems with your login, please contact the policyholder maintenance line at 1-800-421-1834 ext. 6176.

Learn More About COPIC Coverage

Get a Free Quote