0 Congratulations on completing the classroom training phase of the Remote Emergency Technician course! In order to earn your Remote EMT qualification, you must have 24 hours of hands-on clinical experience. Your Remote EMT certificate will be issued when you have submitted your clinical placement record sheets and these have been approved by the course director. You have six months to complete this process. ⇒ CoROM can arrange a clinical placement to you at Saint James Hospital, Malta, in the Intensive Care Unit. › There is no extra cost for this. ⇒ You can choose to arrange your own clinical placement as long as you have prior approval from CoROM. - This placement should be at you local hospital or with a volunteer ambulance service. It can also be event medical cover or a first aid post. › When you arrange for a clinical placement yourself, make sure that the person in charge of the location is willing to give you their contact details and job title (...as well as name and signature for the clinical placement record sheets). Record sheet submissions cannot be accepted without these details. Please indicate your choice:*I would like to request a clinical placement at Saint James IMCU.I want to organise my own clinical placement. - I am not sure where yet. - Will give you details later, by email.I want to organise my own clinical placement. - I can give you details. As noted above: This placement should be an observation at you local hospital or with a volunteer ambulance service. It can also be event medical cover or a first aid post. You will need to document 24 hours and have the person in charge while you make your observations sign off on it. › Make sure that the person in charge of the location is willing to give you their contact details and job title to pass on to CoROM. You do not need to give us those details in advance, but they have to accompany the record sheet submission. › When you submit this form, you will receive an automatic response email. When you have decided where to do your clinical placement, please write to CoROM, describing where you plan to go, so we can approve it. Please describe the clinical placement location:*This format of this placement is "two 12-hour shifts, 7 am to 7 pm".I would like to start the placement on or around the following date...* Date Format: DD slash MM slash YYYY Personal DetailsName* First Last Email* Liability WaiverClinical Placement Opportunities provided by the College of Remote and Offshore Medicine Foundation Liability Waiver You are preparing to attend a clinical placement provided by CoROM. During this time you will be operating in areas of risk. You may be exposed to risks of infection with communicable, air-borne and vector-borne diseases. You are responsible for your own safety, health care, health insurance, travel insurance and vaccinations during this time. By clicking on the “I understand the risks...” button below, you release and hold harmless CoROM, all parties employed by, and any organisation affiliated with CoROM for training and clinical placements. You acknowledge that CoROM cannot be held responsible for any costs or liabilities associated with these placements or any other risk or liability not covered in this statement. You understand that CoROM is solely a facilitor of this clinical placement opportunity.Please confirm: I understand the risks described in the above Liability Waiver, and agree to proceed with my booking of this clinical placement. Privacy* By using this form you agree with the storage and handling of your data by this website. * When you submit this form, we will send you a confirmation email the record sheet that you will need to use to document your clinical placement This iframe contains the logic required to handle Ajax powered Gravity Forms.