Understanding of Clinical Participation Requirements Form

Arkansas Tech University- Ozark Campus Paramedic/Emergency Medical Service Program uses external affiliated agencies for clinical experiences for our students. Affiliated agencies may impose requirements for students in order to be allowed access to clinical experiences.

Students will be required to provide the following information to external affiliated agencies:

  • Health Screening/Immunizations
  • CPR Certification
  • Criminal Background Investigation
  • Drug Testing

The student should maintain copies of the documents listed above. Affiliating agencies may require the student to provide a copy of the documentation.

NOTICE AND RELEASE - READ CAREFULLY BEFORE SIGNING

I, the undersigned applicant to the Paramedic/EMS Program at Arkansas Tech University- Ozark Campus, understand that participation in a clinical experience is part of the Paramedic/EMS Program and that participation in a clinical experience includes working as a student at an affiliating agency. I understand that I will be responsible for all travel, meals, and lodging associated with clinical education. I further understand that affiliating agencies have the right to establish requirements for participation in clinical experience. I understand that I am responsible for providing copies of the documentation requested by the affiliated agency. I understand and agree that if I am rejected for participation in a clinical experience by an affiliating agency or if I refuse to submit to checks or tests that are required by an affiliating agency in order to participate in a clinical experience, I may be unable to complete my program of study and graduate from the Paramedic/EMS Program. I hereby release Arkansas Tech University- Ozark Campus, its employees, and all affiliating agencies from any liability with regard to my participation in a clinical experience and decisions made concerning my participation in a clinical experience.