HomeMy Public PortalAbout118-2020 - Fire - Franklin County EMS - Student Affiliation Agreement0R
F I D RICHMOND FIRE DEPARTXM%4 '
�J EMS EDUCATION
Adult Education
Emergency Medical Technician Course
Clinical Affiliation Agreement
This clinical site agreement has been designed for Franklin County EMS. Your organization has been chosen to
provide prehospital clinical experience to Emergency Medical Technician students. As a clinical site for the Richmond
Fire Department EMS Education program you are responsible for the following:
1. The clinical site will ensure that the EMT student receives a meaningful clinical experience with a proper
preceptor in a professional atmosphere. .
2. The clinical site will provide appropriate personal protective equipment to each student.
3. The clinical site shall encourage hands on experience for the student while remaining within the student's
scope of practice. Students will not be allowed to perform any procedure for which they have not been
properly trained.
4. The clinical site will never release total patient care to the student and will provide an approved preceptor
appointed by the clinical site at all times.
5. All students will arrive to the clinical site in approved attire and appropriately groomed. Students failing to
meet proper dress/appearance guidelines may be sent home by the clinical site.
6. Scheduling procedures are to be outlined by the clinical site and the training institution will ensure the policy
is followed.
7. Students provide their own health insurance and are responsible -for any injuries that may occur while at a
clinical site, in or around a clinical site apparatus, at a clinical site emergency scene, or at a clinical site
affiliated hospital. An RFD EMS Education Waiver and Release will be maintained in each student's file for
the duration of the course.
8. Any student not -abiding by training institution, clinical site, or hospital policy, acting in an unprofessional
manner, or not following appropriate dress/appearance guidelines may be subject to dismissal from the
clinical site and may be removed from the EMT program.
9. The clinical site agrees to treat all students equally and fairly, and shall not discriminate with regard to age,
race, color, creed, gender, sexual preference, veteran status, national origin, or disability.
This agreement is found to be acceptable by the following appropriate party:
City of Richmond Board of Public Works & Safety for the Richmond Fire Department
In witness whereof, the parties have executed this agreement as of the date set forth: // 2020
Signature Signature
Vicki Robinson Roy Rosenberger
President, City of Richmond Board of Public Works & Safety President, Franklin County EMS
David M. Snow
Mayor, City of Richmond
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Signature
Benjamin Simmons NRP;EMS-PI
RFD EMS Education Training. Institution Official
Contract No. 118-2020