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Physician Application Materials

  1. Colorado Health Care Professional Credentialing Application
    1. Be sure to save the application to your local computer before you start completing it. Otherwise, you will not be able to save your changes or
    2. A previously completed CO state application with an "Effective" date of 2011 (see bottom of each page) or later, updated and re-signed.
  2. Privilege request form and all required documentation described therein.
    1. If requesting any of the following, see additional Privilege Criteria: Fluoroscopy, Moderate Sedation, or Ventilator Management.
  3. Addenda and all required documentation described therein (checklist included for your convenience):

Initial Applicants

If you are going to be employed by Boulder Community Health, complete:

See: