Forms, Surveys, and Sign-Ups

Student Tracking Release of Information Consent Form

HCC wants to track our students’ progress from graduation through college and beyond. This data will help us understand how to help more students gain access to careers in healthcare. We will track students using the National Student Clearinghouse, which is a national resource for college enrollment and degree data. The information students give on this form allows us to track their academic journey, with no additional effort from them. Their personal information will not be shared with anyone outside the HCC.
Click here to dowload consent form to print.

Consent to Release Photograph and Video Recordings

Please note that every participant in the HCC is required to complete the HCC photo/video release form. If a participant elects not to complete the release form, it is the responsibility of the HCC site to ensure that no photos or videos of that individual are shared.

Download and print the HCC release form by clicking here.

Google Form photo/video release form (alternative if no printer available)

Pre- and Post Surveys for High School Participants

These surveys have been approved by the IRB. Individual HCC sites will be given access to the results to better understand the efficacy of their program and for scholarly activity.

Pre-survey: Please ask high school student participants to complete the pre-participation survey before your first session. Copy and paste this link to send to students:

Post-survey: Please ask high school student participants to complete the post-participation survey after your last session. Copy and paste this link to send to students:

Every student who completes the survey will be entered into a raffle for a $50 Amazon Gift card.

Request for Intuitive Surgical Robotics Engineer Pop-In Guest

Click here to submit request (1st and 2nd choice date and time) to have a surgical robotics engineer zoom into a HCC session to discuss the career of a robotics engineer and answer questions.

Office Hours with Dr. Gefter

Dr. Gefter is offering 30 min office hour times on the first Wed. and third Thurs. of each month. Sign up for a slot here. If none of those times work for you, please email Dr. Gefter with your availability.