Williamson County EMS Third-Out Rider/Observer Information Form
THE CONTENT ON THIS PAGE IS ESSENTIAL TO YOUR ACCEPTANCE TO RIDE.  PLEASE READ ALL!


*  Williamson County EMS third-out riders must complete and sign the Request for Approval to Ride and Third-Out Rider Information Form
*  No person under the age of eighteen (18) will be permitted to ride as a third-out rider in the WCEMS ambulance or Officer or Unit at any time unless prior approval has been granted by Director or Director of Operations.
*  Williamson County EMS third-out riders may ride a maximum of one time per 12 month period unless approved by the Director.
*  No students currently enrolled in an EMSP will be allowed to engage in these rides.
*  No students using EMS rides for course credit or projects can be allowed to engage in these rides.
*  Riders will carry at least one KN95 mask.  Riders will supply their own appropriately sized mask.
*  Williamson County EMS Third-Out Rider should appear at the scheduled time.  If the Third-Out Rider arrives after the assigned time, the Third-Out Rider has the responsibility of rescheduling the riding period to another date.
*  Violation of any portions of the prohibited acts, or dress code, or any behavior that impairs the EMS crews ability to perform his/her job, will be considered grounds for being banned from riding.

------------------------------Dress Code For Williamson County EMS Third-Out Riders------------------------------
*  Williamson County EMS Third-Out Riders are to dress neatly and conservatively.
*  Dark pants or slacks and a polo style shirt are required.  Blue jeans are not acceptable.
*  Cleanliness is required at all times.
*  Hair and facial hair must be well groomed.
*  Clothing bearing any sign or symbol that advertises any product, business or organization will not be permitted.
*  Clothing with offensive designs, logos, letters or devices is prohibited.
*  Conservative type shoes or boots may be worn; sandals and bare feet are prohibited.

-------------------------------------------------------------Prohibited Acts----------------------------------------------------------------
*  Will not consume alcoholic beverages 8 hours prior to scheduled ride-out or during tours of duty.
*  Will not use profane or abusive language during the tour of duty.
*  Will not make remarks or voice opinions to patients, complainants, witnesses, victims, violators or suspects in any manner which would tend to provoke or degrade anyone or escalate tension.
*  At no time will observers be permitted to take pictures, use a video camera or any other audio-visual recording device while on the scene of an incident.  
*  Requests for media third-out rides/observers will be dealt with separately through EMS Director or EMS Deputy Director.

------------------------------------------Williamson County EMS Third-Out Riders Will--------------------------------------
*  Comply with Health Insurance Portability and Accountability Act
*  Complete HIPAA provided training upon arrival for Third-Out Ride
*  Understand and sign HIPAA compliance form
*  Follow instructions in a positive and cooperative manner.
*  Not engage in any activity that can be considered detrimental to WCEMS or Williamson County.
*  Obey the law.

I have read, understand and agree with the information contained herein and will abide by it.

THIS FORM IS TO BE FILLED OUT ONLY BY PERSONS 18 OR OLDER.
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