St Mary's Medical Center

EMS Student Clinical Rotation Program

Thank you for choosing St. Mary’s Medical Center for your Emergency Medical Services (EMS) educational experience.  Please review the Helpful Hints document prior to submitting your information and scheduling your clinical rotation.

The documents provided must be completed in their entirety and submitted to EMS Outreach at St. Mary’s Medical Center prior to attending your clinical rotation.  If you have any questions please contact your primary instructor or the following:

  • 970-298-7683
  • 1-800-458-3888 ext. 7683 or 2424


  1. Review and complete the Instructor Checklist.
  2. Please send your course rosters on your agency letterhead to us before your students call to make appointments. We cannot schedule them unless we have a roster.
  3. Please make sure we have an updated/current copy of your insurance coverage.
  4. Students must have their paper work completed in FULL prior to calling for clinical scheduling.
  5. Please have your students bring the necessary paperwork from your agency that they need filled out – we do not have copies of the paperwork for them.
  6. Review Student Checklist


  1. Review and complete the Student Checklist. It is your responsibility to have all paperwork completed and delivered to your instructor prior to submission.
  2. Students will not be permitted to register for clinical times until paperwork is completed. 
  3. All required documentation is below.

Student Background Check: Must have St. Mary’s logo and boxes on bottom of page, HR will not accept if not on the right form.  Please make sure the student has signed and dated the form and also filled in school name and program (Basic, Intermediate, Advanced, Paramedic).

EMT Student Memorandum of Understanding:  Make sure the student has filled in each immunization date; “see attached sheet” is not acceptable, the only immunization the student can waive is the Hepatitis B, and the declination statement at the bottom of the second page must be signed.

Student Confidentiality Agreement: This is self explanatory please call me if you have any questions regarding this form

Student Orientation checklist with signature page: This form is to show that the students have seen the PowerPoint show.  This is St. Mary’s way of giving them a shortened orientation to our hospital without attending a formal class that is held here once a month for 5 days.

Quizzes:  Review the EMS Student Orientation presentation and then complete these quizzes.  Cultural Diversity Quiz, HIPAA Quiz, Safety Quiz, OR Clinical Questionnaire.

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