EMR APPLICATIONS AND THIS DOCUMENT ARE ALL DUE BY FRIDAY, AUGUST 18, 2016.

MAXWELL HIGH SCHOOL OF TECHNOLOGY EMERGENCY MEDICAL RESPONDER PATHWAY

EMR APPLICANT PARENT AND STUDENT AGREEMENT AND ACKNOWLEDGEMENT

2016-2017 SCHOOL YEAR

I acknowledge the following information and agree with the following criteria for participation in the EMR pathway certification pathway. In order to be considered for the EMR pathway, student, ______, will be required to have current BLS Healthcare Provider Certification. Once the student has been accepted to the program, the student must meet the following criteria needed to qualify to test for the National Registry Emergency Medical Technician (NREMT) EMR psychomotor skills certification and the written CAT (computer adaptive test):

Attendance and competence in skills is required in order to sit for the National Registry Emergency Medical Technician (NREMT) certification exam. Please go to for more information.

  • Verification from the program director. Monica Collins, RN, that the student holds a current CPR-BLS for Healthcare Providers or equivalent credential AND have demonstrated competence in Emergency Medical Responder (EMR) skills.
  • Student must have a Social Security Number in order to test for the national exam.
  • Criminal background checks are done through the NREMT not Maxwell High School.
  • There is no age requirement to sit for the NREMT- EMR certification exam.
  • Student must attend class every day (95% attendance during the second semester) and can only have 1 excused absence and no unexcused absences for skill practice sessions at Gwinnett Technical College or Gwinnett County Fire and Emergency Services Fire Station #20.
  • Student must maintain a 75% class average throughout the second semester. If a student does not maintain this class average, they will not be able to certify. Therefore any fees paid will be non-refundable!Parents if you do NOT have access to the portal in order to monitor your student’s grade and attendance, please enroll at your student’s home school. This is imperative!
  • Once a student passes the NREMT skill performance exam, they will be required to take EMS platinum EMR practice exams in preparation for the CAT. If your student does not pass allpractice exams with 70% or above, your child will not be able to sit for the exam. Therefore they will forfeit all fees paid.
  • Fee deadlines (non-refundable):
  • Pearson Vue testing blocking fee:$15.00 due by December 16, 2016
  • Pearson Vue seat fee: $10.00 due by February 3, 2017
  • NREMT application fee:$65.00 due by March 31, 2017
  • Please note: Maxwell High School is paying for online book access at $25/ student and the EMS platinum testing fee of $20/student. This will allow students to practice for the written certification exam in May.
  • Uniform fees include the following:
  • Stethoscope
  • Watch with a second hand
  • EMT pants to be purchased by the student
  • EMR polo which will be ordered in class in September. Cost approximately $35.00
  • EMR T-shirt is optional. Cost is approximately $20.00

If a student decides they will NOT certify as an EMR but they would like to take the class, they must notify the instructor immediately. Any fees paid prior to this notification will be forfeited. The uniform is not negotiable. A student must wear EMT pants and EMR polo for trainings off site and for testing situations. By signing this agreement, I confirm that I am aware of the above criteria. If I would like to study this pathway but not be certified as an EMR, I will notify the instructor immediately. The instructor will notify parents, when the criteria above have not been met and the fees are forfeited.

Student Signature: ______Date: ______

Parent Signature: ______Date: ______

Student, ______, WILL OR WILL NOT, sit for the EMR pathway exam with the National Registry of Emergency Medical Technicians. If at a later date of this agreement, the student/parent do not wish to sit for the exam, they will continue to receive the training but will forfeit any fees given prior to that that date. If a student does not meet attendance, skill competence, 75% grade or better during the second semester, the parent will be notified as soon as possible. All fees will be forfeited and nonrefundable. All fees are subject and criteria are subject to change.