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 Healthcare Provider Questionnaire Introduction

Colorado Revised Statute § 8-4-125 requires supplemental healthcare staffing agencies (SHSAs) that provide temporary staffing placements to healthcare facilities in Colorado to submit biannual reports to the Division of Labor Standards and Statistics (DLSS). The data DLSS collects is then shared with the Colorado Departments of Public Health and Environment (CDPHE) and Health Care Policy and Financing (HCPF) for purposes of analyzing the data and determining the need for the regulation of staffing agencies.

In an effort to identify which agencies need to report, CDPHE and HCPF gather information about agencies being utilized from healthcare providers. The purpose of this questionnaire is to update the list of staffing agencies used by healthcare providers in the state.
You do not need to complete this questionnaire because you did not use a Supplemental Healthcare Staffing Agency during 2026.

 Healthcare Provider Questionnaire - Staffing Agencies Used

Healthcare Provider Information







e.g. XXX-XXX-XXXX

e.g.(@somplace.com)

Your Contact Information


e.g., General Counsel, Compliance Director, etc.

e.g.(@somplace.com)

Please review the list below and select each supplemental healthcare staffing agency (“SHSA”) you have used to fill temporary staffing placements during 2026.

NOTE: If you do not see an agency that you use, please select " My agency is not listed" at the bottom of the list and provide the agency information.

Please use the space below to enter the information of the supplemental healthcare staffing agency (“SHSA”) you have done business with.






e.g. XXX-XXX-XXXX

e.g.(@somplace.com)


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