Students who are from out of state may or may not be able to pull rotations outside of Texas. CAAHEP standards for Paramedic students now state that EMS Education Programs must have an agreement with a licensed Emergency/EMS physician, signed agreements with the sites, and approval of each state outside of their home license state. PERCOM currently has a Medical Director in the states of Texas, Ohio, Vermont, Georgia, Missouri, Utah, New Jersey, Arizona, Iowa and southern Idaho. We may or may not have current affiliation agreements with hospitals or EMS in those states at the time you wish to rotate so please check when it is close to time for you to start rotations if you have any questions. PERCOM does not guarantee affiliation agreements will not change over time or even that the site you choose will accept you for rotations at their facility at the times, dates, or time frames you request. Also, PERCOM cannot and will not be held responsible or accountable for changes in state rules or CAAHEP standards that may affect students while in the program.