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Ride-Along Program Registration Form


  1. 1. HIPAA Code of Ethics
  2. 2. Waiver
  3. 3. Applicant Information
  • HIPAA Code of Ethics

    1. HIPAA Code of Ethics*

      The obligations of confidentiality which professional code of ethics and HIPAA Laws have placed upon the Firefighter/EMT also applies to all other personnel who are riding with and working with members of the Fairborn Fire Department. Under no circumstances may any information gained within the activities of the Fairborn Fire Department from any patient, EMT, or otherwise be divulged to any person except in the course of duty.

      Any infraction of this obligation of confidentiality will result in removal from the Ride-Along Program. I agree to accept the above obligations as part of the responsibilities of working with the members of the Fairborn Fire Department.