TEXAS SOUTHERN UNIVERSITY
COLLEGE OF PHARMACY & HEALTH SCIENCES
DEPARTMENT OF HEALTH SCIENCES
HEALTH INFORMATION MANAGEMENT PROGRAM
GENERAL INFORMATION
 Place completed applications in a sealed envelope.
 Health Information Management Professional Program (HIM) courses begin each fall
semester. There is only 1 class admitted per year. Applications are accepted January 1
through April 1 of each year for the Fall semester. Application submitted after the
deadline is considered non-responsive.
 Applicant interviews are held the last two weeks of April preceding the Fall Semester.
 Applicants must have been accepted to the University.
 Transfer/Advanced Standing applicants meet both the requirements for admission into the
university and those of HIM program.
 Applicants are required to take the HOBET Health Sciences Entrance examination.
 Examination dates are March 8 at 9:30am and November 9 at 9:30 a.m. late arrivals
will not be seated. There are no additional examination dates. The cost includes
examination, application fee, and processing $_50.00_ and is non-refundable.
 Applicants are required to register for examination 2 weeks prior to exam date.
 Students may review The Education Testing Bureau (www.hobet-success.com for more
information).
Required Documents and Submission Process
HIM application
official transcripts
Transcript evaluation
Typed narrative describing applicant background and interest in profession
(maximum 2 pages)
3 Recommendations(1 instructor, 1 employer, 1 other) (use attached forms )
HOBET entrance examination fee (money order payable to Texas Southern
University –Department of Health Sciences)
Place documents in a sealed legal size envelope with your name and program for
which you are applying.
Submit envelope containing all documents to the Health Sciences main office NSC
202. You must verify your submission by signature.
Applicants will be notified of application status within 30 days of receipt of a
completed application.
HEALTH INFORMATION MANAGEMENT PROGRAM
PLEASE PRINT OR TYPE:
Name (Last)
_____________________
I D Number
(First)
(Middle)
______________________
Cell Phone
________________________
Current Telephone
_______________________________________________________________
E-Mail Address
________________________
Permanent Telephone
Current Address
Zip Code
City
State
Permanent Address
Zip Code
City
State
EDUCATIONAL INSTITUTIONS ATTENDED- List in Chronological Order (Last Institution First) All Colleges, Universities,
or Other Post Educational Institutions Attended.
Name of Institution (Do Not
Abbreviate)
Dates
Attended
Credits Earned
Semester (S) or
Quarter (Q)
System
Credit System
(Circle One)
Degrees/Certificates
Earned (if any)
S
Q
S
Q
S
Q
S
Q
S
Q
HOBET FEE INCLUDED:
___________ YES
________NO
Applicant Signature _______________________________Date:_______________
Submit typed narrative (maximum 2 pages) and attach to application.
Texas Southern University
College of Pharmacy and Health Sciences
Health Information management Program
Applicant Recommendation Form
Applicant Name: ______________________________
TO THE RECOMMENDER: The above-named student has applied for admission to the Health Information
Management Program. Someone who has previously taught this student and has known the applicant for at least oneyear period must complete this section. We appreciate your frank appraisal of the student. Your recommendation may
be given to the student in a sealed envelope or you may mail it to: Texas Southern University College of Pharmacy and
Health Sciences HIM Program 3100 Cleburne Houston, Texas 77004.
1. Please evaluate the applicant on following characteristics by checking the appropriate number. The applicant
should be rated on a scale of 1-10 (with “1” representing the lowest rating, and “10” representing the highest
rating. If you are unable to rate a particular characteristic, please enter “NA” which will indicate unknown.
Please attach a letter of recommendation as desired.
CHARACTERISTIC
1
2
3
4
5
6
7
8
Personal Appearance
Academic Ability
Self-Confidence
Work Habits
Motivation Towards Program
Seriousness of Purpose
Potential for Contribution /
Commitment to Profession
(enthusiasm professional demeanor
knowledge level)
Resourcefulness and Initiative
(self starter, work habits, followthrough, ability to work
independently)
Maturity( self control emotional
stability acceptance of constructive
criticism)
Adaptability
Communication skills
oral
written
listening
Teamwork (ability to work with others,
cooperative disposition)
Reliability (promptness,
conscientiousness, dependability)
Integrity (moral character, honesty)
Leadership skills (ability to inspire
confidence)
Intellectual curiosity ( interest in learning,
active, learner, creative thought)
Empathy (sensitivity to needs of others,
caring attitude toward others)



How long have you known this applicant? _________________________
In what capacity have you known the applicant? _____________________
Your best estimate of the applicant’s overall potential for success in the ___________________
program.
______Poor _______Below Average ______Good _____Outstanding
Additional Comments:
Recommender’s Printed Name___________________________________
Recommender’s Signature____________________________________Date_______________________
Recommender’s Title _______________________Employer __________________________
9
10
Department of Health Sciences Application Checklist
APPLICANT PROCESSING CHECK LIST
PROGRAM:__________________________________
SEMESTER: _________________________________
LAST NAME: __________________FIRST NAME___________________
T-NUMBER:__________________________________
Transcripts Included check:
YES
NO
COMMENTS:
Complete Incomplete
APPLICATION
LETTERS OF
RECOMMENDATION (3)
ESSAY
GPA
TRANSCRIPTS
TRANSCRIPTEVALUATION