Briar Oaks Fire Department

Ride-alongs give community members, prospective recruits, and EMS / fire-science students an inside look at what we do. Complete the form below to request a date — a member of the department will follow up to schedule.

All requested ride-alongs require a background check, completion of HIPAA training, and a signed liability waiver. Please review the policies in the Requirements section before submitting.

Applicant Information

First Name: *

Last Name: *

Date of Birth: *

Phone: *

Email: *

Street Address:

Apt / Suite:

City:

State:

Zip Code:

Request Details

Requested Date: *

Start Time: *

Duration (Hours): *

Preferred Member:

Purpose: *

Requirements & Policies

Check each box to indicate you have read and agree to each statement.

Age Requirement. I acknowledge that I am at least 18 years old & that a background check will be performed before riding out.

Patient Confidentiality. Prior to participating, every participant who may come into contact with private health-related information will be required to complete Health Insurance Portability and Accountability Act (HIPAA) training and sign a nondisclosure agreement to keep all confidential information learned during the ride-along confidential.

Good Health Clause. I must be in good health on the day of the ride-along and must not be suffering from any illness or injury, including cold, flu or respiratory infection.

Waiver of Claims and Release of Liability. Prior to participating, I will acknowledge the risks and sign a written waiver of claims and release of liability. Please download, print, and sign the Liability Waiver & PHI Confidentiality Form and bring it with you on the day of your ride-along.

Suitable Attire. I will be suitably dressed in dark pants or jeans, a plain t-shirt or polo, tennis shoes or boots, and appropriate weather attire. Sandals, tank tops, shorts, and ripped jeans are not permitted. Jewelry and tattoos must comply with departmental policy.

Officer Authority. I understand that a Lieutenant or above may refuse or end a ride-along if I fail to adhere to these policies or fail to follow instructions of the officer in charge.

Certification & Signature

By signing below, I affirm that I have read and agree to all stipulations above, including the Waiver of Liability and Confidentiality of PHI policy. I understand this is a legal representation of my signature.

Applicant Signature *

Sign here using mouse, pen, or finger

By signing, you certify that the information above is accurate.

Questions? Call (817) 295-9530 or email info@briaroaksfire.com.