Clinical Eligibility Policy

Texas Rescue Med, LLC (“Texas Rescue Med,” “TRM,” “we,” “our,” or “us”) requires students to meet all applicable clinical, field, externship, internship, capstone, onboarding, documentation, safety, conduct, and compliance requirements before participating in any patient-facing educational activity.

Policy Statement

Clinical and field education are required components of certain Texas Rescue Med EMS education programs. Clinical and field experiences are designed to validate safe student performance, professional behavior, patient assessment, documentation, communication, clinical reasoning, and certification-level competency under appropriate supervision.

Students may not participate in clinical or field activities until all assigned eligibility requirements have been reviewed and cleared by Texas Rescue Med or the appropriate clinical or field partner.

Scope of This Policy

This policy applies to eligibility for:

• Hospital clinical rotations.
• Ambulance field externship.
• EMS field internship.
• Capstone field internship.
• Ride-along or observation experiences.
• Patient contact documentation.
• Clinical or field skills performance.
• Preceptor-supervised patient care.
• Clinical onboarding and site orientation.
• Any patient-facing educational activity assigned by Texas Rescue Med.

This policy applies to active EMR, EMT, and AEMT programs and to refresher, continuing education, instructor development, agency-based, and specialty courses whenever clinical or field participation is required or assigned. The future Paramedic program is in development and is not currently accepting enrollment; Paramedic-specific requirements below are prospective and will apply only after the program is appropriately authorized and launched.

Clinical Participation Is Not Guaranteed

Texas Rescue Med coordinates clinical and field education in partnership with approved hospitals, EMS agencies, clinical affiliates, field agencies, preceptors, and other educational partners.

Clinical and field placement is dependent on:

• Program requirements.
• Student eligibility.
• Academic progress.
• Completion of required onboarding.
• Clinical site availability.
• Field site availability.
• Preceptor availability.
• Patient volume.
• Schedule availability.
• Site capacity.
• Regulatory or accreditation requirements.
• Student conduct and professionalism.
• Background check, drug screen, and immunization clearance.
• Clinical affiliate approval.
• Field agency approval.

Texas Rescue Med cannot guarantee placement at a specific hospital, EMS agency, geographic location, shift, preceptor, department, unit, or clinical experience type.

Clinical Eligibility Requirements

Before participating in any clinical or field activity, students must satisfy all applicable requirements assigned by Texas Rescue Med and the clinical or field site.

Clinical eligibility may require:

• Active enrollment in good standing.
• Satisfactory academic progress.
• Completion of required prerequisite coursework.
• Completion of required skills preparation or readiness checks.
• Current CPR/BLS certification when required.
• Government-issued photo identification.
• Proof of age when required.
• Immunization records or approved exemption documentation.
• Background check clearance.
• Drug screen clearance.
• Facility-specific onboarding.
• Clinical site orientation.
• HIPAA or confidentiality training.
• Signed clinical agreements, waivers, releases, or acknowledgments.
• Completion of any required online modules or facility training.
• Required uniform, identification, and dress code compliance.
• Approval by Texas Rescue Med program administration.
• Approval by the assigned clinical or field site.
• Financial clearance when required by program policy.

When Screening and Clinical Clearance Occur

Level-Specific Clinical and Field Requirements

Clinical and field requirements vary by EMS education level and program design.

When the future Paramedic program is authorized and begins enrolling, enrolled students will be required to complete all approved clinical, field, competency, procedure, patient contact, team lead, and capstone requirements before completion verification is issued.

Background Check Requirements

Texas Rescue Med coordinates required criminal background checks through Checkr during designated in-person skills or class sessions. TRM initiates the screening invitation, and the student completes required authorizations and identity information through the approved Checkr process. Students do not need to submit a separate public background-check request form. When a clinical or field assignment requires earlier clearance, TRM will provide alternate instructions.

Background-check results must be received and reviewed, and all applicable TRM and site clearance conditions satisfied, before any patient-facing clinical or field assignment. Simply receiving a Checkr invitation or completing the screening questionnaire does not constitute clearance. Clinical and field partners may require additional background checks, fingerprinting, screening, or facility-specific approval; requirements vary by site.

A student may be denied clinical or field placement based on:

• Criminal history.
• Pending charges.
• Prior disciplinary action.
• Background check results.
• Failure to disclose required information.
• Clinical affiliate policy.
• Field agency policy.
• Regulatory or safety concerns.

Admission into a Texas Rescue Med program does not guarantee that a student will be approved by a clinical site, field agency, Texas DSHS, NREMT, or any employer. Texas DSHS and other regulatory or certification agencies retain independent authority to determine certification or licensure eligibility.

Drug Screen Requirements

When a drug screen is required, Texas Rescue Med ordinarily conducts it in person during an approved skills session or designated class session. Students should not independently schedule an outside drug screen unless specifically instructed by TRM. A clinical affiliate, field agency, hospital, EMS agency, or another onboarding partner may impose additional or different testing requirements. TRM will coordinate any necessary alternative screening instructions.

A student may be denied clinical or field placement, removed from clinical or field activities, or dismissed from the program based on:

• Positive drug screen result.
• Refusal to test.
• Failure to complete testing by the deadline.
• Altered, invalid, dilute, or suspicious test results.
• Failure to comply with drug screening instructions.
• Clinical site or field agency denial.
• Safety-sensitive concerns.

Students must follow assigned screening instructions and deadlines. Screening results must be reviewed and applicable clearance granted before patient-facing clinical or field participation. Attendance at the approved class or skills session where testing is performed may precede final screening clearance when TRM authorizes it.

Immunization and Health Requirements

Students must comply with Texas Rescue Med, Texas DSHS, clinical affiliate, and field agency immunization and health requirements before any direct patient contact.

Required immunizations or proof of immunity may include, but are not limited to:

• Hepatitis B.
• Measles, Mumps, and Rubella.
• Varicella.
• Tdap or tetanus-containing booster.
• Tuberculosis screening.
• Annual influenza vaccine when required by the site.
• COVID-19 vaccination or exemption documentation when required by the site.
• Any additional immunization, screening, or health requirement imposed by a clinical affiliate or field agency.

Accepted documentation may include official immunization records, state registry records, military records, laboratory titers, or provider-verified documentation when allowed by policy.

Students must submit all required immunization and health documentation before beginning any clinical or field assignment. Failure to do so may result in delayed participation, removal from clinical or field eligibility, delayed completion, or inability to complete the program.

Medical, Religious, or Conscientious Exemptions

Students may request a medical, religious, or other legally recognized accommodation or exemption as permitted by applicable law, TRM policy, and the requirements of the assigned clinical or field site. TRM will review requests individually and coordinate with the partner site when appropriate. Submission does not automatically grant an exemption or authorize clinical participation, and a clinical or field partner may apply its own lawful entry requirements.

If a clinical site or field agency cannot approve a particular request consistent with applicable law and its requirements, TRM will review whether an alternative arrangement is appropriate and available.

If a student is denied placement because of incomplete immunizations, missing health documentation, or an exemption that is not accepted by a clinical or field site, Texas Rescue Med is not responsible for securing an unlimited number of alternative placements. The student may be unable to complete required clinical or field components.

Refund eligibility is governed by the Texas Rescue Med Refund and Cancellation Policy, enrollment agreement, and applicable law.

Clinical Site and Field Agency Authority

Clinical affiliates and field agencies may establish their own requirements for student participation.

These may include:

• Background checks.
• Drug screens.
• Immunization requirements.
• Health documentation.
• Facility orientation.
• Learning modules.
• Masking or PPE requirements.
• Confidentiality agreements.
• Dress code rules.
• Identification requirements.
• Professional conduct expectations.
• Patient safety requirements.
• Documentation standards.
• Shift scheduling rules.
• Site-specific restrictions on student skills or patient care activities.

Clinical and field sites may deny, restrict, suspend, or terminate student participation based on site policy, onboarding status, safety concerns, conduct concerns, performance concerns, patient care concerns, staffing limitations, capacity limitations, or other site-specific requirements.

Texas Rescue Med will evaluate whether reassignment is appropriate and available, but reassignment is not guaranteed.

Assignment of Clinical and Field Experiences

Clinical rotations, field externships, field internships, and capstone field internships are assigned and coordinated by Texas Rescue Med.

Students do not independently select their own clinical or field sites unless specifically authorized in writing by Texas Rescue Med.

Texas Rescue Med may consider program needs, student progress, site availability, patient volume, preceptor availability, schedule capacity, safety, compliance, and regulatory or accreditation requirements when assigning clinical or field experiences.

Texas Rescue Med reserves the right to modify, reassign, postpone, or terminate clinical or field placements due to:

• Site availability.
• Student performance.
• Student conduct.
• Safety concerns.
• Onboarding status.
• Preceptor availability.
• Patient volume.
• Changes in affiliation agreements.
• Clinical partner restrictions.
• Program deadlines.
• Regulatory or accreditation requirements.

Student Readiness for Clinical or Field Participation

Texas Rescue Med may require students to demonstrate readiness before clinical or field placement.

Readiness may include:

• Completion of required coursework.
• Completion of required exams or benchmark assessments.
• Completion of required skills labs.
• Demonstration of psychomotor competency.
• Scenario-based readiness validation.
• Professional behavior review.
• Documentation training.
• Review of scope-of-practice expectations.
• Review of HIPAA and confidentiality rules.
• Review of clinical dress code and conduct expectations.
• Completion of all assigned onboarding documentation.

Texas Rescue Med may delay or deny clinical eligibility when a student has not demonstrated adequate academic, psychomotor, affective, safety, documentation, or professionalism readiness.

Student Scope of Practice in Clinical and Field Settings

Students may perform only skills that:

• Have been taught by Texas Rescue Med.
• Have been authorized for student practice by Texas Rescue Med.
• Are appropriate for the student’s program level.
• Are permitted by the clinical or field site.
• Are allowed by applicable Texas EMS education and scope expectations.
• Are approved by the assigned preceptor or instructor at the time of performance.
• Are performed under required supervision.

Educational exposure in lab does not independently authorize a student to perform a skill on a live patient.

Students may not:

• Perform skills beyond their student authorization or certification level.
• Make independent medical decisions.
• Administer unauthorized medications.
• Perform invasive procedures without required authorization and direct supervision.
• Document as the primary provider on an official agency patient care report unless specifically allowed by the site as a supervised educational activity.
• Function as agency personnel.
• Be counted toward staffing requirements.
• Perform any procedure prohibited by Texas Rescue Med or the clinical or field site.

Students must immediately stop any activity if directed to do so by a preceptor, instructor, clinical staff member, site supervisor, or Texas Rescue Med representative.

Duty to Decline Unsafe or Unauthorized Procedures

Students have a duty to decline any procedure, task, assignment, or patient care activity if:

• The student has not been trained.
• The student has not been authorized by Texas Rescue Med.
• The student does not feel competent.
• The task exceeds the student’s program level or legal scope.
• The clinical or field site does not permit the activity.
• The preceptor’s request conflicts with Texas Rescue Med policy.
• The activity would compromise patient, student, staff, or public safety.

Students must notify Texas Rescue Med immediately if they are pressured to perform an unauthorized, unsafe, or inappropriate procedure.

Supervision and Preceptor Oversight

Clinical and field activities must occur under appropriate supervision.

Students must:

• Follow preceptor direction.
• Obtain permission before participating in patient care activities.
• Identify themselves as students.
• Remain within the authorized student role.
• Request clarification when expectations are unclear.
• Report safety, professionalism, or patient care concerns promptly.
• Complete all documentation accurately and honestly.
• Accept feedback professionally.

Preceptors, clinical staff, field supervisors, instructors, or Texas Rescue Med representatives may remove a student from patient care activity if safety, professionalism, scope, health, compliance, or performance is in question.

Student Work Policy

Students participating in Texas Rescue Med clinical, field, laboratory, simulation, externship, internship, or capstone activities are participating for educational purposes.

Students are not employees of Texas Rescue Med or any clinical or field affiliate by virtue of enrollment.

Students may not be used to replace staff, meet staffing requirements, or provide services in place of compensated personnel.

Students will not receive wages, stipends, or other compensation for activities performed as part of program requirements unless separately and formally employed in a role entirely independent of student status and educational activities.

Clinical Dress Code and Identification

Students must comply with the Texas Rescue Med clinical dress code and any additional site-specific requirements.

Clinical dress expectations may include:

• Clean, professional, program-approved uniform.
• Closed-toe footwear appropriate for clinical or field settings.
• Limited jewelry and no items creating safety hazards.
• Hair secured and grooming consistent with clinical site expectations.
• Visible student identification unless otherwise directed.
• Compliance with all clinical or field site dress code policies.

Failure to comply with dress code or identification requirements may result in removal from the clinical or field shift and may count as an absence.

Transportation Requirement

Students are responsible for transportation to and from all clinical sites, field assignments, externship shifts, internship shifts, capstone shifts, classes, labs, and skills sessions.

Lack of transportation does not excuse missed clinical or field assignments and does not waive completion requirements.

Emergency Vehicle Operation Prohibition

Students participating in clinical, field, externship, internship, or capstone activities are not permitted to operate any emergency vehicle at any time.

This prohibition includes ambulances, response vehicles, fire apparatus, supervisory vehicles, and other agency vehicles.

Students may not drive, reposition, park, refuel, move, or otherwise operate emergency vehicles during assigned student activities.

Attendance and Completion of Clinical or Field Hours

Students must complete 100% of assigned clinical, field, internship, externship, and capstone requirements.

Students must attend clinical and field shifts as assigned. Clinical and field availability is limited and dependent on partner facilities and EMS agencies.

Students are responsible for completing all required:

• Clinical hours.
• Field hours.
• Patient contacts.
• Procedure competencies.
• Skills documentation.
• Preceptor evaluations.
• PCR or documentation assignments.
• Capstone or team lead requirements when applicable.

Failure to complete clinical or field requirements by program deadlines may result in delayed completion, ineligibility for a course completion certificate, repeat of the clinical component, re-enrollment in a future class, administrative withdrawal, or dismissal.

Clinical and Field Absences

Students must notify both Texas Rescue Med and the assigned clinical or field site as early as possible if they are unable to attend a scheduled clinical or field shift.

Unless a more specific program rule applies, students should notify Texas Rescue Med and the clinical or field site at least two hours before the scheduled shift start time when possible.

Unreported absences, late cancellations, no-call/no-show absences, repeated tardiness, or failure to follow site notification procedures may result in disciplinary action, removal from clinical eligibility, loss of makeup eligibility, administrative withdrawal, or dismissal.

Makeup Clinical or Field Hours

Makeup clinical or field hours are not guaranteed.

Makeup hours may be considered for:

• Illness or injury.
• Documented emergency.
• Pre-approved absence.
• Facility-initiated cancellation.
• Other circumstances approved by Texas Rescue Med.

Makeup hours are subject to:

• Clinical site availability.
• Field site availability.
• Preceptor availability.
• Program deadlines.
• Student eligibility.
• Site approval.
• Administrative capacity.

Work conflicts, transportation issues, voluntary scheduling changes, failure to plan, or no-call/no-show absences are not guaranteed makeup eligibility.

Texas Rescue Med may charge a clinical makeup fee for student-requested makeup shifts, except in cases of facility-initiated cancellation, when permitted by program policy.

Limits on Clinical or Field Absences

Students may miss no more than the maximum number of clinical or field hours allowed by the applicable program policy.

Missing excessive clinical or field hours may result in dismissal if makeup opportunities are unavailable.

Texas Rescue Med cannot guarantee makeup opportunities when:

• Clinical site capacity is limited.
• Field site capacity is limited.
• Preceptors are unavailable.
• Site blackouts or seasonal limitations exist.
• Program deadlines are approaching.
• The student is not permitted to return due to conduct, safety, or performance concerns.
• The student has excessive absences.

Documentation Requirements

Students must complete all clinical and field documentation accurately, honestly, and by the assigned deadline.

Documentation may include:

• Clinical or field shift logs.
• Patient contact documentation.
• Procedure documentation.
• Medication administration documentation.
• Skill competency verification.
• Preceptor evaluations.
• Student evaluations of clinical or field experiences.
• PCR exercises or approved patient care documentation.
• Capstone team lead documentation when applicable.
• Exposure, incident, or safety reports when required.

Falsification of clinical or field documentation is a serious academic integrity and patient safety violation and may result in immediate dismissal.

Preceptor Evaluations

Students must obtain required preceptor evaluations according to Texas Rescue Med policy and program deadlines.

Missing, incomplete, inaccurate, or unsatisfactory preceptor evaluations may delay completion or require additional clinical or field experiences.

Students are responsible for ensuring that assigned documentation is completed and submitted through the approved system.

Patient Confidentiality and HIPAA Compliance

Students may encounter protected health information during clinical and field activities.

Students must comply with HIPAA, Texas Rescue Med confidentiality policies, clinical affiliate privacy rules, field agency policies, and all patient confidentiality requirements.

Students must not:

• Discuss patient information outside authorized educational or clinical settings.
• Post patient information, images, scenes, times, locations, or descriptions on social media.
• Remove, copy, photograph, or transmit clinical documents containing patient identifiers.
• Share PCRs, patient names, medical details, or clinical cases with unauthorized individuals.
• Submit patient-identifying information through public website forms, unsecured email, text messages, or unauthorized systems.

Suspected privacy breaches must be reported immediately to Texas Rescue Med.

HIPAA or privacy violations may result in removal from clinical sites, disciplinary action, dismissal, reporting to regulatory bodies, and potential civil or criminal penalties.

Exposure Control and Reporting

Students must follow Texas Rescue Med, OSHA, Texas DSHS, and clinical partner policies regarding exposure to blood or other potentially infectious materials.

Reportable exposures may include:

• Needle sticks or sharps injuries.
• Contact of blood or other potentially infectious material with non-intact skin.
• Mucous membrane exposure involving eyes, nose, or mouth.
• Significant respiratory exposure when applicable.
• Any incident in which the student believes a potential exposure occurred.

Students must immediately notify:

• The on-site clinical preceptor.
• The Program Director or Course Coordinator.
• The clinical site charge nurse, supervisor, or designated site representative as required by facility policy.

Students must seek immediate first aid, comply with occupational health evaluation, complete required exposure documentation, and submit required documents to Texas Rescue Med by the assigned deadline.

Failure to follow exposure procedures may result in removal from clinical or field sites or dismissal.

Safety and Professional Conduct

Professional conduct and safety are mandatory during all clinical and field activities.

Students must:

• Follow all site policies.
• Use appropriate PPE.
• Practice safe body mechanics.
• Follow infection control procedures.
• Communicate professionally.
• Accept preceptor and instructor feedback.
• Maintain patient confidentiality.
• Remain within student scope.
• Report unsafe conditions.
• Maintain emotional control and professional behavior.
• Avoid harassment, discrimination, bullying, dishonesty, or disruptive conduct.

Unsafe, dishonest, unprofessional, discriminatory, harassing, retaliatory, threatening, or patient-safety-related conduct may result in immediate removal from clinical or field activities and possible dismissal.

Removal From Clinical or Field Activities

Texas Rescue Med, a clinical affiliate, a field agency, a preceptor, or site representative may remove a student from clinical or field activities for reasons including, but not limited to:

• Unsafe patient care.
• Scope-of-practice violation.
• Failure to follow preceptor direction.
• Failure to comply with site policy.
• Dress code violation.
• Tardiness or absence.
• No-call/no-show.
• HIPAA or confidentiality violation.
• Falsification of documentation.
• Academic dishonesty.
• Drug or alcohol concerns.
• Positive drug screen or refusal to test.
• Background check concern.
• Professional conduct concern.
• Patient, staff, student, or public safety concern.
• Failure to meet onboarding requirements.
• Failure to maintain clinical eligibility.

Removal from a clinical or field site may delay program completion and may result in remediation, reassignment when available, administrative withdrawal, dismissal, or ineligibility for course completion.

Clinical Site Denial or Termination

If a clinical or field site denies, restricts, suspends, or terminates a student’s placement, Texas Rescue Med will review the circumstances and determine whether reassignment, remediation, additional documentation, administrative withdrawal, dismissal, or another action is appropriate.

Texas Rescue Med is not required to secure unlimited alternative placements.

If no acceptable placement is available, or if the student cannot meet clinical eligibility requirements, the student may be unable to complete the program.

Financial Holds and Clinical Eligibility

Students must remain current on financial obligations according to the applicable enrollment agreement, invoice, payment agreement, refund policy, and student handbook.

A past-due account or financial hold may restrict:

• LMS access.
• Skills lab participation.
• Clinical scheduling.
• Field scheduling.
• Internship scheduling.
• Capstone participation.
• Testing.
• Completion verification.
• Graduation clearance.

Financial holds do not, by themselves, change earned academic grades. However, failure to complete required clinical or field components because of a financial hold, nonpayment, or administrative withdrawal may prevent course completion.

Administrative Withdrawal or Dismissal

A student may be administratively withdrawn or dismissed if the student:

• Fails to meet clinical or field requirements.
• Fails to maintain required certifications.
• Fails to maintain immunization compliance.
• Fails to maintain background or drug screen clearance.
• Fails to complete required onboarding.
• Fails to meet academic or psychomotor requirements needed for clinical readiness.
• Fails to meet affective or professionalism expectations.
• Violates patient safety, confidentiality, scope, or site policy.
• Fails to complete clinical or field documentation.
• Misses required clinical or field assignments.
• Is denied placement by clinical or field partners.
• Fails to meet financial obligations required for continued participation.

Administrative withdrawal or dismissal does not guarantee eligibility for a refund.

Appeals

Students may appeal a clinical eligibility decision, clinical or field removal, placement denial, documentation decision, preceptor evaluation concern, administrative withdrawal, dismissal, financial hold, or related administrative decision according to the Texas Rescue Med Complaint, Grievance & Appeals Policy and Student Handbook.

Unless a more specific written policy provides a different deadline, appeals must be submitted in writing within fifteen (15) calendar days of receiving notice of the decision being appealed.

Submission of an appeal does not automatically suspend clinical deadlines, field deadlines, financial responsibility, disciplinary action, administrative withdrawal, dismissal, or other program requirements unless Texas Rescue Med approves such suspension in writing.

Relationship to Other Policies

This policy should be read together with the Texas Rescue Med Student Handbook & Program Manual, Program Disclosures, Privacy Policy, Terms of Use, Refund and Cancellation Policy, Accessibility & Accommodation Policy, Complaint, Grievance & Appeals Policy, course syllabus, enrollment agreement, clinical site requirements, and official written communications.

If a more specific written document applies to a student, course, clinical placement, field placement, payment plan, or signed agreement, the more specific written document may control unless otherwise required by law.

Contact Texas Rescue Med

Questions about clinical eligibility, field placement, clinical onboarding, clinical documentation, preceptor communication, or clinical completion tracking may be directed to Texas Rescue Med through an official communication channel.