CO - CSC Initial Training for Independent Contractors

Consumer Specific Competency Initial Training

For Colorado Independent Contractors
Contractor Name*

First NameLast Name
Office Location
Consumer Name*

First NameLast Name
Name of Trainer with Credentials or Title:*

First NameLast Name Credentials / Title
Date

MonthDayYear
Date
Training Time ( Duration of Training will be auto calculated once times are entered)*

:HourMinutesAM/PM Option
to
until :HourMinutesAM/PM Option
Check mark each specific skill area when training has been completed and competency demonstrated. Skills listed for which staff did not receive training should NOT be check marked.*
List what Specialized Protocols training (if checked above):
Additional Notes regarding Consumer Specific Training on topics not listed above:
Employee Signature Date

MonthDayYear
Date
Employee Signature*
Trainer Signature Date

MonthDayYear
Date
Signature of Trainer Below indicates that the employee has demonstrated the expected level of competency in the skills areas check marked above.
Trainer Signature / Credentials*
Should be Empty:

Consumer Specific Competency Initial Training