Thanks for your Participation in Class today. We have attached some links to some resources for your reading enjoyment.
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Course Registration information
Location or Course
Number: {field:location_or_course_number_please_ask_instructor_1609725468638}
First Name: {field:firstname}
Last Name: {field:lastname}
Email: {field:email}
Phone: {field:phone}
Covid
Score
{field:covid1}/NO
{field:covid2}/NO
{field:covid3}/NO
{field:covid4}/NO
You have agreed to the following
Course Expectations and Liability Waiver
COURSE EXPECTATIONS ANDLIABILITY WAIVER
To successfully complete this course
· Participate in all practical skills, class discussions and watch and pay attention to all
course videos
Health and Safety
There are risks and dangers inherent in participating in any emergency care course.
The risks include, but are not limited to injuries during skill practice and the possibility of acquiring communicable diseases.
Reasonable precautions to safeguard the participants health and safety during training include:
Please let the instructor know if you have any physical limitations, please do not put yourself in a position that may cause injury to yourself
Please let the instructor know if you have any physical limitations, please do not put yourself in a position that may cause injury to yourself |
·
·
Students that have a Contagious illness should notify the instructor so that the appropriate precautions can be taken.
· Please watch for trip hazards
· No Smoking, Vaping, Smokeless tobacco or alcohol during class
Liability Waiver
Knowingly I assume all risks inherent with this class and hereby voluntarily release and hold harmless EMS Training Resources, ASHI, each of their officers, agents, employees,
and volunteers harmless from liability or costs from injury associated with or arising
from my participation in this class including from negligence I understand and Agree
that this release applies to personal injury, including from death,and property damage that
I may suffer
I have read and understand this agreement: {field:covid_policy_1609725597304}
COVID – 19 |
· Students should practice social distancing and
wear face coverings asper state ordinance and facility protocol
· Students should feel free to disinfect the
manikins after reach student use, with the provided disinfectant.
· Students will use gloves with all manikin practice,
Ø Students should perform hand hygiene, at regular intervals
Ø DO not preform Mouth to Mouth on the manikins
I have Read and understand the following
{required_1609719636229}
COVID-19 Questionnaire
Have you experienced any of the following symptoms in the past 48 hours
• fever or chills
• cough
• shortness of breath or difficulty breathing
• fatigue
• muscle or body aches
• headache
• new loss of taste or smell
• sore throat
• congestion or runny nose
• nausea or vomiting
• diarrhea
Answer: {field:covid1}
Within the past 14 days,
have you been in close physical contact (6 feet or closer for a cumulative total of 15 minutes) with: Anyone who is known to have laboratory-confirmed COVID-19?
OR
Anyone who has any symptoms consistent with COVID-19?
Answer {field:covid2}
Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19?
Answer {field:covid3}
Are you currently
waiting on the results of a COVID-19 test?
Answer: {field:covid4}