All members of the MAG Medical Reserve Corps (MRC) shall meet the standards of conduct. As a member of the MAG Medical Reserve Corps I am expected to conduct myself as follows:

Ethical Conduct:

Maintain and abide by the standards of my profession, including licensure, certification and/or training requirements to support my MRC role.

Not act in the capacity of a MRC responder, nor present myself as an MRC volunteer, at any given site without prior authorization/deployment from the MAG MRC.

Dress for the environment. Wear closed toe shoes if activated.

Avoid profane and abusive language and disruptive behavior including behavior that is dangerous to self and others including acts of violence, physical or sexual abuse, or harassment.

Avoid situations that could be interpreted as a conflict of interest as an MRC member.

Abstain from the use of university or county equipment/resources for personal use.

Abstain from transport, storage and/or consumption of alcoholic beverages and/or illegal substances while performing volunteer duties.

Abstain from responding for duty under the influence of alcohol or illegal substances or under the influence of prescription/non-prescription medication that may influence my ability.

Refrain from carrying any weapons on my body for personal use.

Abstain from the use of audio or video recording equipment, unless authorized.

Keep contact information current with MAG MRC.

Safety:

Put safety first in all volunteer activities.

Respect and use all equipment appropriately.

Promote healthy and safe work practices.

Take care of self and others.

Report injuries, illnesses and accidents to MAG MRC Director.

Respect:

Respect the cultures, beliefs, opinions and decisions of others although I may not always agree.

Treat others with courtesy, sensitivity, tact, consideration, and humility.

Accept the chain of command and respect others regardless of position.

As a MRC member, I shall not:

Comment, answer questions or divulge any information to the media.

Accept or see on behalf of myself or any other person, any financial advantage or gain as a result of my affiliation with the Medical Reserve Corps.

Public use any MRC affiliation in connection with the promotion of partisan politics, religious matters, or positions on any issue.

Disclose or use confidential MRC information that is available solely as a result of my affiliation with the MRC to any person not authorized to receive such information.

Knowingly take any action or make any statement intended to influence the conduct of the MRC in such a way as to confer any financial benefit on any person, corporation or entity in which the individual has significant interest or affiliation.

Authorize the use of or use for the benefit or advantage of any person, the name, emblem, services or property of the MRC, except in conformance with MRC policy.

As a volunteer for the Medical Association of Georgia Medical Reserve Corps have read and understand the Code of Conduct of the Medical Association of Georgia Medical Reserve Corps and agree to comply with the code as it is set forth in the attached document.

Medical Association of Georgia Medical Reserve Corps Confidentiality Agreement

I realize that as a member of the MAG Medical Reserve Corps, in association with the institutions and agencies supported, I may acquire knowledge of confidential information from files, case records, missions, conversations, etc. I agree that such information is not to be discussed or revealed to anyone not authorized to have the information.

By my signature below, I hereby affirm that I understand the rules of patient confidentiality as governed by the Health Insurance Portability and Accountability Act (HIPPA) and by accepted standards in healthcare.

I understand that a patient's privacy is to be protected at all times, and that a patient's private personal and health information is to be shared only with other health care and public safety providers who have a need to know such information in order to appropriately assist in or take over the care of said patient.

I hereby accept my ethical and legal responsibility to protect the privacy rights of patients for whom I provide or assist in medical or personal care. I will share a patient's medical and personal information only with those who must have that information to assist in or take over that patient's care.

The undersigned, being at least eighteen years of age or with parental consent if under eighteen, and in consideration for acceptance, approval and participation in the Medical Association of Georgia Medical Reserve Corps for emergency response, events, and training and exercises, does hereby agree to this consent, waiver and release of liability.

Acknowledgement and Assumption of Risk

I recognize that my volunteer service will involve physical labor and may carry a risk of personal injury. I further recognize that there are natural and manmade hazards, environmental conditions, diseases and other risks, which in combination with my actions can cause injury to me. I hereby agree to assume all risks, which may be associated with or may result from my participation with MAG MRC.

I recognize that these MAG MRC activities will involve physical activity and may cause physical and emotional discomfort. I state that I am sufficiently physically fit to volunteer with MAG MRC.

Waiver and Release of Liability

I agree to release the State of Georgia, the Medical Association of Georgia, their agencies, departments, officers, employees, agents and all sponsors and/or officials and staff of any said entity or person, their representatives, agents, affiliates, directors, servants, volunteers, and employees (hereinafter referred to collectively as “Parties Released”) from the cost of any medical care that I receive while volunteering with MAG MRC or as a result of it.

I further agree to waive, release and discharge the Parties Released from any and all liability, claims, demands, actions, and causes of actions, whatsoever, for any loss, claim, damage, injury, illness, attorney’s fees or harm of any kind or nature to me arising out of any and all activities associated with MAG MRC volunteer service or as a result of it.

I further agree to indemnify, save, and hold harmless the Parties Released from and against any and all claims of any nature, including all costs, expenses and fees, arising out of or resulting from my volunteer service with MAG MRC.

Consent

In the event of injury while volunteering in any and all activities associated with MAG MRC volunteer service, I consent to receive any emergency medical aid, anesthesia, and/or medical treatment or operation if, in the opinion of the attending physician, such treatment is necessary.

I, the undersigned participant, affirm that I am at least 18 years of age or have parental consent, and am freely signing this agreement. I have read this form and fully understand that by signing this form I am giving up legal rights and/or remedies, which may otherwise be available to me regarding any losses I may sustain as a result of my participation. I agree that if any portion is held invalid, the remainder will continue in full legal force and effect.

I also understand that either the MAG MRC and its affiliates or I may cancel this agreement at any time by notifying the other party.

Medical Association of Georgia Medical Reserve Corps Receipt of Handbook

I have read an electronic copy of the Medical Association of Georgia Medical Reserve Corps handbook. I can also request an electronic copy via emaill. I have read and understand the policies and information in it and agree to abide by these policies during my volunteer term.

Medical Association of Georgia Medical Reserve Corps Photo Release

The Medical Association of Georgia Medical Reserve Corps respects the privacy of its volunteers.

Therefore, we request your permission to use your name, likeness, voice, and quotations as needed for broadcast media, publications, promotion, and/or public education. Please read and sign the appropriate statement below to grant this permission.

By signing below, permission is granted indefinitely. This permission may be revoked in writing at any time.

This consent does not apply to photos required for security identification.

I hereby permit the Medical Association of Georgia Medical Reserve Corps to use my name, likeness, voice, and quotations as needed for broadcast media, publication, promotion, and/or public education.