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HCC Online Advising and Counseling Form

* = Required fields

*Last Name:   *First Name:   Middle Initial  

Student HCC ID: Help   *Date of Birth: (mm/dd/yyyy)    

*Email:   *Preferred Contact Number:   Best Time to Contact:  

Preferred Method of Contact:      

Special Student Status:          

    Additional HCC Departments may be found on their websites ( Financial Aid , Bookstore , Veterans , International Students , Library Services )
*Please provide details related to your need(s) in the comment box.

Online Confidentiality Form

All Internet/e-mail/telephone/face-to-face discussions are kept private except, by law, information of endangerment to others, abuse or injury to a protected group member. Limitations and/or exceptions to confidentiality include:

  • when a client poses danger to self or others,
  • when a protected group member (i.e. someone under age 16 or over age 65) is the victim of child/elder abuse, rape, or incest,
  • when the client needs hospitalization,
  • when information is needed, via subpoena, in court action,
  • when a client makes a written request for the release of information to self or third party,
  • and, or when the counselor confers with another HCC colleague for advisement.
Houston Community College (HCC) reserves the right to monitor Internet and email usage, and this poses the possibility that someone, an outside third party, may see the text of your e-mail. We are unable to assure the confidentiality can be maintained, but we will make every effort to assure privacy. If you are concerned about the contents of your e-mail being read by someone other than the individual you are contacting, then you should choose an alternate means of contact. If you believe the HCC Online Advising and Counseling Center staff member is behaving unethically you may contact the HCC Online Director.

The information on this form is confidential and may contain information that is privileged. It is intended solely for the prospective student or student; access to anyone else is unauthorized.

I have read and understand the exceptions to privacy and limits of confidentiality for the HCC Online Advising and Counseling Center.

Please press the Submit button only ONCE. Your request will be processed momentarily.