Dalton State CollegeApplication for Admission

Baccalaureate of Science Health Information Management

FallCohort- School Year __2018_

School: Health Professions

Department: Health Information Management

Degree: Baccalaureate of Science in Health Information Management

*Applications for fall admission must be submitted by April 1st

  • Read the application instructions thoroughly before completing each item on the application
  • Incomplete applications will be not be considered
  • Returning students who have not attended Dalton State College for three or more consecutive semesters must fill out a Readmit Form (found on the A-Z Index, R – Registrar, Current & Former Students Applications & Forms) to be considered for admission.

Personal Data

Name

Address

Current DSC ID Number

Home Number

Cell Number

DSC Email

Alternate Email

Educational Information

List all colleges and universities you have attended (most recent first).

School nameCity/State/ZipDates attendedGraduated Y/N

School nameCity/State/ZipDates attendedGraduated Y/N

School nameCity/State/ZipDates attendedGraduated Y/N

What is highest level of degree you have earned?

Do you have any current certifications?

Answer the Following Questions

  1. Do you currently work in a health care environment? Yes No
  1. Do you work in a medical records department? Yes No
  1. Do you have experience with billing and coding? Yes No
  1. Are you currently RHIT certified? Yes No
  1. Are you a member of AHIMA?Yes No
  1. Are you interested in becoming an AHIMA member?Yes No
  1. Are you aware that the HIM major field courses require you to attend

DSC as a full-time student?Yes No

  1. Are you aware that the major field courses are offered online? Yes No
  2. Are you aware that there are internship requirements that require

you to be onsite in a medical records or similar office setting?Yes No

  1. Have you ever participated in online learning? Yes No
  1. Do you have access to a computer with internet capabilities? Yes No
  1. Is your GPA at least a 2.5? Yes No
  1. Have you completed all of the required pre-requisite courses? If no, list the courses you have not taken. Yes No
  1. Pre-requisite courses not completed
  1. Which academic year was listed on the DSC Course Catalog when you chose this major?
  2. Are you planning to CLEP any of the major field courses for HIM? If yes, which courses? Yes No

Course(s) you plan to CLEP

  1. Are you aware that if you do not pass a HIM major field course, you will not be able to progress in the program until the course is offered again the next academic year? Yes No
  1. On a separate page, write an essay explaining why you would be a good candidate for this program. The essay should include a description of why you are interested in HIM, your work and collegiate values, where you hope this degree will place you in the workforce, and any plans to continue your education.

*Completed application packets with essay should be submitted to by the March 1st deadlilne

1 / BSHIM Application Packet 2018