HCC Coleman College Dental Hygiene Program
Fall Application Packet
Application Deadline: April 8, 2016, 12:00noon
Thank you for your interest in the Coleman College for Health Sciences Dental Hygiene Program. The dental hygiene
education curriculum is scientifically oriented, rigorous and intensive. Total enrollment is based on facility capacity and
specific program admissions criteria. These procedures are necessary to ensure that the students that are selected have the
potential for successfully completing the program.
Admission to the dental hygiene program is selective and competitive. Selection is based on a formula of specific criteria
along with an interview. Interviews are by invitation only. Once the interview process is completed, twenty (20) candidates
will be offered entrance into the fall semester class.
Please read all of the information in this packet to assure that you will submit a completed application. Student Services
and the dental hygiene program will not consider an incomplete application. It is your responsibility to assure that your
application is complete. The complete application packet and required supporting documentation must be sent as ONE
DOCUMENT to Student Services. Do not send any information directly to the dental hygiene department.
HESI Information - Two options are available for students to complete the HESI Exam:
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HCC Dental Hygiene ID: 201615 (offered at the HCC Central College Campus)
Elsevier Dental Hygiene ID: 198647 (Prometric Testing Center)
The Dental Hygiene ID must be provided when registering for the HESI exam. Any HESI exam taken without the appropriate
Dental Hygiene ID number will automatically disqualify your application.
Please choose Version 1 if this is your first time taking the exam for this application period, otherwise choose Version 2.
Repeated failures of the test require remediation by Elsevier. Houston Community College DOES NOT offer Remediation
services for the HESI exam.
For more information about the HESI and Elsevier, please visit the Dental Hygiene Program website:
http://www.hccs.edu/media/houston-community-college/coleman-college/pdfs/dhyg/DHYG_HESI.pdf
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APPLICATION PROCEDURE
*DO NOT SUBMIT an application until ALL REQUIREMENTS and PAPERWORK are COMPLETE*
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Complete the Houston Community College Application (Not required for current HCC students)
http://www.hccs.edu/district/students/apply/
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Complete the Coleman College for Health Sciences Application
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Complete the Dental Hygiene Program Application (attached)
Request and submit official high school transcript or GED scores/diploma to Student Services Center
Complete the Texas Success Initiative as required by HCC by being TSI “Complete” in Reading, Writing and Math. (If
you are unsure if you meet the qualifications, speak with an Advisor)
Submit an official transcript from each College/University you have attended (Unofficial Transcripts from HCC are
acceptable) showing proof of completion of all prerequisite and co-requisite courses with a minimum grade of C.
If you attended school outside the United States, you are required to attach a transcript evaluation.
Submit HESI exam scores with a cumulative score of 70% or better.
All information must be included with your application to be complete and eligible for submission. Any piece of
documentation missing from your application packet will result in the disqualification of your application.
Application packets sent directly to the Dental Hygiene Department will NOT be accepted. All materials must be
delivered directly to the Student Services Office in person or by mail by 12:00noon on the deadline date.
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http://www.hccs.edu/media/houston-community-college/coleman-college/pdfs/201507-health_sciences_application.pdf
HCC Coleman College for Health Science
Student Services Department
1900 Pressler Street
Houston, TX 77030
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Please notify us directly of any name, address, or phone change as soon as possible.
PLEASE RETAIN COPIES OF YOUR APPLICATION MATERIALS FOR YOUR RECORDS
Students will be notified by email of their admission status.
Applications are destroyed at the end of each application period. Therefore, if you are not accepted for this application
period, you must reapply again next year with new documentation.
All statements related to admission criteria or announcements of present policies are subject to revisions as needed.
Any advice given by the dental hygiene department regarding coursework does not insure acceptance into the
program.
Admission Guidelines for the Dental Hygiene Program
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Admission is determined on an objective basis using a quantified point scale designed to accurately predict successful
completion of the program.
All pre-requisite and co-requisite science courses must be completed within 5 years of application deadline date.
All required pre-requisite as well as co-requisites course work must have a minimum grade of C
HESI test scores must be within 12 months of application deadline date with a cumulative score of 70%.
Mandatory 16 Hours of Observation of a Registered Dental Hygienist must be completed within 1 year of application
Autobiographical Essay will be objectively reviewed and evaluated
Interviews will be offered by invitation only
All students accepted into the program are required to complete and submit a cleared background check, physical
examination, necessary vaccinations, and proof of current medical insurance coverage.
Students with felony convictions may not be allowed to be licensed by the State of Texas to practice dental hygiene.
Please contact the Texas State Board of Dental Examiners (512.463.6400) for additional information.
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PERFORMANCE REQUIREMENTS
To be successful in the dental hygiene program, students must be able to meet the following performance standards:
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Professional attitude during all phases of the application process. If at any time during the process, it is determined
that your attitude or actions are unprofessional, your application may not be considered for acceptance.
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Visual acuity with corrective lenses to identify oral tissue changes and evaluate treatment effectiveness.
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Hearing ability with auditory aids to understand the normal speaking voice without viewing the speaker’s face and
take/hear blood pressure with a stethoscope.
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Physical ability to sit for long periods of time, perform repetitive wrist motion activities for instrumentation, move
from room to room, and maneuver in limited spaces.
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Written and verbal communication skills to succinctly describe patient conditions, document findings in a patient
record and implement oral health teachings. English language fluency in speaking, reading and writing is
mandatory.
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Manual dexterity to use a variety of instruments in the small, confined space of the oral cavity.
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Function safely under stressful conditions with the ability to adapt to an ever changing environment in clinic
situations involving patient care.
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Computer skills to use a variety of software programs and the Internet for research and course projects. Proficiency
with Microsoft Power Point is necessary for presentation purposes.
HCC Coleman College for Health Sciences does not discriminate against qualified applicants with disabilities in any of its programs including the Dental
Hygiene Program, Coleman College makes available disabilities counselors in its Student Counseling Department to assist persons interested in seeking
admission to any program to understand the program requirements and determine whether and how their disability can be accommodated in the
program. In addition, a person with disabilities who is interested in pursuing a career in dental hygiene might wish to consult with a dental professional
concerning whether the nature of the disability may be an impediment to hiring in the specific office settings in which you have interest before
commencing the program. No dental hygiene applicant will be denied acceptance on the basis of disease status, such as HIV, HBV or HCV. In the
occurrence of an infected applicant, the Rules & Regulations established by the State Board of Dental Examiners (SBDE) state the health care provider
must notify patients and obtain their written consent to be treated, thus, completing clinical educational requirements may be difficult. In the event
that the student completes the program, the SBDE may deny licensure. Therefore, in the instance of such disease status, career counseling may be in
order.
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HCC Coleman College Dental Hygiene Program
Application for Admission
PERSONAL INFORMATION
Name: ________________________________________________
HCC Student ID Number: __________________
Other Names under which credentials may be received: ____________________________________________________
Street Address: _____________________________________________________________________________________
City: _______________________________________________ State: ____________
Zip Code: __________________
Primary Phone Number: _______________________________ Alternate Phone Number: ________________________
Email Address: ______________________________________________________________________________________
US Citizen: Yes _______ No* _________
Permanent Resident: Yes ________ No* ________ (If Yes, please provide a copy of your permanent resident card)
*If you answered ‘NO’ to the previous two citizenship questions, the Texas State Board of Examiners will not allow licensure for employment. Please
consult the Texas State Board of Dental Examiners at 512.463.6400 should you have questions or concerns or require further information. HCC Coleman
College for Health Sciences is not responsible for denial of licensure.)
EDUCATION INFORMATION
Please list ALL educational institutions (colleges, universities, professional schools, etc.) that you have attended in order of
attendance. Do not omit the name of any institution where you have been a student. If you need additional space, please
feel free to use a separate sheet of paper.
School #1
Name of School:_____________________________________________________________________________________
Dates Attended: __________________________ to ___________________________
Degree/Certificate Awarded: Yes ______ No ______ Degree/Certificate Type:__________________________________
School #2
Name of School:_____________________________________________________________________________________
Dates Attended: __________________________ to ___________________________
Degree/Certificate Awarded: Yes ______ No ______ Degree/Certificate Type:__________________________________
School #3
Name of School:_____________________________________________________________________________________
Dates Attended: __________________________ to ___________________________
Degree/Certificate Awarded: Yes ______ No ______ Degree/Certificate Type:__________________________________
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HCC Coleman College Dental Hygiene Program
Application for Admission
EMERGENCY CONTACT INFORMATION
Please provide the contact information of person(s) to be contacted in case of an emergency:
Full Name: ____________________________________ Relationship: _________________________________________
Street Address: _____________________________________________________________________________________
City: _______________________________________________ State: ____________
Zip Code: __________________
Primary Phone Number: _______________________________ Alternate Phone Number: ________________________
Email Address: ______________________________________________________________________________________
APPLICATION VERIFICATION
I certify that the information provided in this application and ALL supporting documentation is correct and complete. I
understand that omission or falsification of any information is grounds for exclusion or dismissal. If accepted into the
program, I agree to meet all entrance requirements and to conform and abide by the requirements and the spirit of the
rules, regulations and procedures of Houston Community College System and the Dental Hygiene program.
Signature: ______________________________________________________
Date: ___________________________
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AUTOBIOGRAPHICAL ESSAY
Write an autobiographical essay. Include examples of your participation in activities such as community service, work
experience along with extracurricular activities, etc. In addition, please describe your interest in the dental hygiene
profession emphasizing those interests which would enhance your career as a dental hygienist. Please keep your concise
response limited to this sheet of paper in Times New Roman size 12 font.
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Dental Hygiene Course List
Listed below are the Dental Hygiene Core Curriculum Requirements. In the space provided, please indicate the semester
and year you completed the course (example: Fall 2011). If you have not completed the course, please indicate the
semester and year you anticipate completing the course (example: Spring 2016).
Course Name
EXAMPLE
ENGL 1301
English Comp I
Semester Year
Completed
Fall 2011
***Complete Shaded Sections ONLY***
College where course
was completed
HCC
Credit Hours
(Office Use Only)
Course Grade
(Office Use Only)
Quality PTS
(Office Use Only)
SOCI 1301
Intro Sociology
CHEM 1305
Intro Chemistry
BIOL 2401
A&PI
BIOL 2402
A & P II
BIOL 2420
Microbiology
SPCH 1318
Interpersonal
Communication
PHIL 2306
Intro Ethics
PYSC 2301
Intro Psychology
Please contact Mr. David Pereida, Academic Advisor for the Dental Hygiene Program, for more information about course
substitutions:
Phone: 713.718.5060
Email: david.pereida@hccs.edu
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STUDENT ENROLLMENT DISCLOSURE
Ethical behavior and honesty are of utmost importance in the Dental Hygiene profession. As such, we require all students
considered for admission into the HCC Dental Hygiene Program to disclose their previous enrollment in any other Dental
Hygiene program by completing and signing the form below.
Student Full Name: _______________________________________________________________________
1. Have you previously attended any dental hygiene program? Yes ______
2.
No _____
If yes, which school(s) did you attend?
Name of School:_____________________________________________________________________________
Dates Attended: __________________________ to ___________________________
Name of School:______________________________________________________________________________
Dates Attended: __________________________ to ___________________________
3. Please briefly explain why you left the program:
Signature: ______________________________________________________
Date: ___________________________
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