Colorado Health Care Professional Credentials Application
Mandated by 25-1-108.7, Colorado Revised Statutes.
- Colorado Health Care Professional Credentials Application, 6 CCR 1014-4
- official rule as published in the Code of Colorado
Regulations. (Amended 9/21/11, effective 10/30/11)
- This Word version enables you to open the form, save the form to your system, type in your answers and save the completed copy to
your system for future printing and/or updating.
- Microsoft Word and PDF fillable versions of the official application are also available on the COPIC Web site.
- Recredentialing
- Health Care Credentials Application Review Committee
Questions regarding the content of the Colorado Health Care Professional Credentials Application form should be directed to
Al Schwindt at 720-858-6038 or aschwindt@copic.com
The Colorado Department of Public Health and Environment is unable to provide technical support for your download or use of the form. If you experience problems in those areas, please contact your credentialing entity.
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