6 ccr 1014 4-2026

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The document outlines the Colorado Health Care Professional Credentials Application, mandated by the State Board of Health to standardize the credentialing process for healthcare professionals in Colorado. It provides a uniform application form that healthcare practitioners must complete to submit core credentialing information to various health care entities, reducing duplication and costs. The document includes detailed instructions for filling out the application, required documentation, and attestation questions regarding the applicant's professional history and qualifications.

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Click ‘Get Form’ to open the Colorado Health Care Professional Credentials Application in the editor.
Begin by filling out the Identifying Information section. Enter your full legal name, including any suffixes, and provide your contact details such as home address and email.
Proceed to Current Practice Setting(s). List your primary practice location, including the name of the clinical practice, address, and type of practice setting. Ensure you include office hours and contact information.
In the Licenses/Registrations/Certificates section, detail all relevant licenses and certifications. Be sure to indicate whether they are active or expired and provide expiration dates where applicable.
Complete the Education section by listing all educational institutions attended in chronological order. Include degrees received and dates of attendance.
Finally, review all sections for accuracy before signing and dating the application. Use our platform's features to save a copy for your records before submission.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (202 Votes)
2011	4.4 Satisfied (114 Votes)

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