EMERGENCY EDUCATION
AGREEMENT FOR USE OF FACILITY
NAME OF INSTITUTIONS:
.
TERMS OF AGREEMENT
This agreement is made and entered into by and between the __________________and ______________________for the purpose of providing observation and clinical time requirement for students enrolled in Emergency Medical Tech-Paramedic classes taught by instructors of ___________
It is mutually agreed that there shall be no discrimination on the basis of a person’s race, color, creed, religion, national origin, ancestry, citizenship, gender, sexual orientation, age or disability.
This contract shall remain in effect subject to termination as noted below.
Students enrolled in Paramedic classes shall schedule the required clinical time with the designated agent of_______________________. They shall be precepted by Paramedics, Registered Nurses. and or Physicians who agree to supervising students. Students may perform assigned patient care tasks within the student’s scope of training under direct observation of their preceptor. Students shall have completed ten successful IV insertions prior to scheduling time with_____________________. Paramedic students shall also provide a copy of Professional Liability Insurance $1,000,000/$5,000,000. Students agree to one attempt per skill per patient. Students shall have on file with the program director proof of vaccinations and tuberculosis testing.
All students will sign confidentiality statements. Students will be subject to removal from the training program if student is found in violation of established policies and procedures.
All students are regarded as volunteers and are not eligible for worker’s compensation by either ___________________________________- or______________________________________.
___________________________shall provide emergency care for the students while on duty. Charges rendered will be billed directly to the students. __________________________and __________________________will not be responsible for illness or injury occurring to students during clinical time.
NATURE OF AGREEMENT: The parties intend that an independent contractor relationship will be created by this Agreement__________________________ is not to be considered an agent, partner or employer of any student nor is any student considered to be an agent, partner or employee of __________________________while performing student clinical training activities.
INDEMNITY AND COMPARATIVE RESPONSIBILITY: Each party to this agreement shall indemnify and hold harmless the other party, including its officers and employees from any and all claims, demands and liabilities for personal injury, death, disability, loss and damages (including litigation expenses and attorney’s fees) asserted by any claimant arising out of its negligent acts or omissions during the terms of the Agreement.
In the event a court of competent jurisdiction makes a final determination as to the comparative negligence of the parties to this Agreement, then each party shall pay its proportionate share of expenses, costs and attorney’s fees incurred in the defense of the claim.
TERMINATION AND RENEWAL: This Agreement may be terminated by either party upon six months written notice to the other party without cause. This Agreement may be terminated for a material breach of its terms by either party upon written notice specifying the breach, after failure to cure a breach within a reasonable time specified in the notice. Termination for cause shall be effective on the date specified in the notice if the breach is not timely cured. This Agreement may be reviewed annually. If the Agreement is renewed without notification, such renewal must be evidenced by a letter or agreement signed by the officials authorized to execute the original Agreement on behalf of each party.
BY_______________________________ BY_____________________________
Title______________________________ Title____________________________
Date