Colorado Health Networks Online Forms

* The "Submit" button for the form is located on the last page in the lower right corner. The "Reset" button for the form is located on the first page in the top right corner.

If you get an error message or a blank page while filling out CHN's DACODS or CCAR online forms, please read Questions 1, 2, and 3 after you click here: Frequently Asked Questions All users of this page can now use Adobe Reader 7.0 ! Users can also use Adobe Reader 8.0 or continue to use Adobe Reader 6.0, if they choose. If you use Adobe Reader 8.0, please download the newer version 8.1. It works much better with these forms than 8.0. CHP encourages Providers to use this site for CCARs, but will continue to accept CHN's new paper CCAR form. If you do not receive any of the new paper forms or enough of the new paper forms, please call 1-800-804-5008. Do not make copies. The state of Colorado will not accept any of the old CCAR forms, you must use the new form. The new paper CCAR form ID is CCAR 072607. You can find this number on the bottom right of each page. If that is NOT the number you see, please refresh the page and click Frequently Asked Questions and read question #3.

DACODS Admission Form DACODS Differential Assessment Form DACODS Discharge Form DACODS Detox Form DACODS Pregnancy Form CCAR Example: Questions With None CCAR Form

* These forms are in the Adobe "PDF" format.  Your browser will need to already have the Acrobat Reader plug-in to use the form.  If you do not have this plug in already or if you have a version lower than 6.0, you can download Adobe Reader 8.0 using the image link below or an older version using the second link.

Link to directly download Adobe Reader 8.0

Link to directly download an older version of Adobe Reader other than 8.0
 

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