Ride-Along request

This is a request form, not a confirmation. Submitting this form does not mean your ride-along has been scheduled. The LREMS scheduling coordinator will review your request and reach out directly to confirm whether your ride can be accommodated and on which date(s).

Approval is required and not guaranteed. Please plan ahead — the typical turnaround from submission to confirmation is one to two weeks. Submitting last-minute or for dates within the next several days may not leave enough time to schedule you.

Any common format is fine (651-555-1234, (651) 555-1234, etc.)

Scheduling & Logistics

Shift policy: Riders ride full shifts only — no partial shifts. All ride-alongs are scheduled on day shift unless other arrangements are made directly with the LREMS scheduling coordinator.

Select each day you are available, one at a time. Add as many as you'd like — your number of rides requested can be fewer than the dates you list.

    Your preference is considered but a specific base is never guaranteed.

    LREMS Ride Along Policy

    General Guidelines:

    1. Any individual who rides with Lakes Region EMS will be under the direct supervision of the crew to which they are assigned. The preceptors can refuse to begin or complete the rider's shift if the preceptors are uncomfortable with the participant's actions, mode of dress, or attitude, or have experienced previous poor performance with the rider. Scheduling coordinator must be consulted prior to sending a rider home.
    2. No riders will be allowed without having a schedule in advance. Scheduling is coordinated by Brandon Trauba at (651) 277-4911 x107. All requests for Ride-Alongs must be pre-approved by Brandon. If you are unable to make a scheduled ride-along you must call Brandon, prior to the start of the shift and notify him. If you call after-hours, please leave a voice mail message.
    3. Riders must be 18 years or older.
    4. Please arrive at the designated base ten minutes early for assigned shifts and be dressed appropriately. Be aware that a crew may be called out right at the beginning of the shift and may not return to the base for an extended period of time. All bases are secured with a combination lock system that is not given to riders. Be sure to bring food or money to buy your meals.
    5. Riders must comply with all LREMS employee policies.

    Dress Code:

    In order for patients, first responders, and others to identify the rider as a part of the team you must wear the following:

    1. Solid white button down shirt (with a collar) and an identifying name tag. Tee shirts and sweatshirts are NOT acceptable. Plain white t-shirts are required to be worn underneath the white shirt.
    2. Dress slacks of a dark color (black or navy blue) with dark socks. Blue jeans, denim pants are NOT acceptable. EMS pants are encouraged. Belts are required.
    3. Black heavy-toed boots are recommended to prevent injury, but black shoes are acceptable. Tennis shoes or sandals are NOT acceptable.
    4. Students or riders from other EMS agencies may NOT wear their uniform or jacket.

    Rider Procedures:

    1. Riders must read and sign a consent and release form.
    2. Riders are not allowed to carry a company radio. Riders will not use company radios or phones. Base phones may be used for short local calls.
    3. All riders will comply with workplace violence and sexual harassment policies.
    4. Riders must follow all orders concerning patient care.
    5. Riders must practice only at their certification level at the direction of the crew. Any skill performed by the rider may only be done if the rider and crew are confident and comfortable with the rider's skill level. However, the following procedures shall not be performed by a rider:
      • External jugular IVs
      • Endotracheal intubation
      • Narcotic administration
      • Patient Care Reports
      • Driving of ambulance or operation of lights and siren
    6. Riders will be given a station tour, ambulance orientation and review of any emergency procedures at the beginning of the shift.
    7. Riders are not allowed to drive the ambulance. Riders may be asked to remain in the ambulance if required for your safety.
    8. Riders will be seatbelted while the vehicle is moving. There is the exception where involvement in patient care may dictate the need to remove the seatbelt. Use good judgment.
    9. Patient care is our top priority. If a critical patient is encountered, the crew may seem to exclude the rider. Be alert to what is happening since your assistance may be crucial in the overall effort of patient care.
    10. Riders must remain in the back during general driving and in response to calls.

    Rider Eligibility:

    1. Must be at least 18 years or older
    2. Must be from a pre-approved training program or affiliated agency
    3. Must be approved by the Ride-Along Coordinator
    4. Lakes Region EMS does allow high school students, who are minors, to ride with the permission of a parent or legal guardian. These riders must have prior approval and be in a career development program. These riders are to be scheduled through Brandon.

    Patient Confidentiality:

    Patient confidentiality is the utmost concern and priority at Lakes Region EMS. Riders should understand and respect patient confidentiality, not only from an ethical standpoint, but from a legal one as well. Car accidents, suicides, homicides, or any other number of incidents have serious legal significance. All information and details of patients and incidents must be kept strictly confidential. Under NO circumstance shall a rider discuss with anyone, other than the assigned crew or management, patient care and incidents.

    Lakes Region EMS hopes to make this experience a positive one and will involve our riders as much as possible. Please understand that there will be the possibility for down time and plan accordingly. Please feel free to bring things to do and/or study during this time.

    Informed Consent and Release for Ride-Alongs

    I hereby consent to participate in the ride-along program offered at Lakes Region EMS. I understand that the purpose of this program is to observe the role of the Emergency Medical Services professionals in their daily work environment.

    Risks

    I understand that I will be riding in an ambulance with the Lakes Region EMS crews as they respond to requests for emergency medical services. I further understand that in responding to such requests, I may be exposed to conditions and situations that are dangerous and traumatic. Such conditions or situations may include, but are not limited to, exposure to communicable diseases transmitted through exposure to blood, bodily fluids, and airborne pathogens; exposure to hazardous materials and chemicals; risk of physical harm as a result of a combative patient. I acknowledge there is a risk of emotional harm that may accompany my exposure to graphic and traumatic scenes that may include significant injuries and death. I further understand that my exposure to such conditions and situations may result in injury, illness or death. I also acknowledge that I may be exposed to risks that cannot be anticipated. It is my understanding that the Lakes Region EMS crew's obligation is to render care and treatment to the patient and therefore the EMS crew may not be able to protect me from the various risks to which I may be exposed.

    Release

    I acknowledge that there are risks involved in my participation in this program. I hereby agree to hold harmless Lakes Region EMS from any claim, damage, illness or loss that I may experience, including physical and emotional injury as a result of my participation in this program.

    Confidentiality

    I further acknowledge that during my participation in this program I may become aware of facts relating to a specific patient's identity and private information, including the patient's diagnosis, treatment, and complaints. I fully understand that the patient's identity and all the facts relating to the care and treatment to any patient are strictly confidential, both ethically and legally. I understand that at no time can any such information be discussed even after I terminate my participation in the program.

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