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888-580-8373 | 952-405-7900

Have a question?

Call CCB at 888-580-8373 or email

CHPC certification forms

Use these forms when applying for or renewing your CHPC certification.

If you are taking the exam at an HCCA event, complete the Event Exam Application associated with that specific event.

If you already submitted 40 CEUs to CCB for your renewal, you do not need to complete the Renewal Application. Pay your certification renewal fee to complete your renewal.

Use this form to submit CEUs to the CCB that are not already pre-approved by the CCB.

CHPC Exam Applications

     PDF CHPC Exam Application

     Online CHPC Exam Application

CHPC Certification Renewal Applications

     Pay CHPC Renewal fee online (only after your 40 CEUs are in your account)

     PDF CHPC Certification Renewal Application

Submit CEUs that are not already pre-approved

     Online Individual Accreditation Application for CEUs

     PDF Individual Accreditation Application for CEUs

Certification renewal extension request

      CHPC Certification Renewal Extension Request form

Testing center special needs

     Request for Special Examination Accommodations

     Documentation of Disability-related needs

Candidate Handbook

     Download the complete CHPC Candidate Handbook in PDF format