Work History

Patient Consent, Disclosure, and Assignment of Benefits

Timeline

Sloane Brown

Georgetown,Texas

Work History

Flight Paramedic

Allegiance Air 1

Kirbyville, TX

11.2025 - Current

FLIGHT EXPERIENCE

Flight Paramedic

Allegiance Air 1 — PHI Contract Program

November 2025 – Present

Provide rotary-wing critical care transport aboard Bell 407 aircraft.
Deliver advanced patient care during scene and interfacility missions utilizing Hamilton T3 ventilators and Sapphire infusion pumps.
Manage mechanically ventilated patients, medication infusions, and time-sensitive critical care interventions in a dynamic aeromedical environment.
Function within a dual-provider flight crew model emphasizing clinical autonomy, crew resource management, and aviation safety.
Completed PHI Hybrid Flight Academy (11/2025), including flight physiology, aircraft operations, safety management systems, and operational protocols.
Maintain compliance with established clinical guidelines, aviation safety standards, and partner agency policies.

GROUND / PREHOSPITAL EXPERIENCE

911 paramedic

Provide advanced life support care in high-acuity prehospital environments.
Perform advanced airway management, medication administration, cardiac monitoring, and trauma care.
Operate independently and collaboratively within multidisciplinary emergency response systems.

CERTIFICATIONS

Texas Certified Paramedic
ACLS, BLS, PALS, PHTLS

SKILLS

Rotary-wing critical care transport
Mechanical ventilation (Hamilton T3)
Infusion pump management (Sapphire)
Crew Resource Management (CRM)
Aviation safety and SMS principles
High-acuity scene and interfacility transport
Collaborated with ground-based emergency teams for seamless transition of patient care upon arrival at medical facilities.
Collaborated with flight crew to ensure safe and efficient patient transfers.
Administered advanced life support techniques during air transport of critically ill patients.

Patient Consent, Disclosure, and Assignment of Benefits

In consideration for my receiving emergency transport and treatment from PHI Health, LLC d/b/a PHI Air Medical ('Provider'), I hereby agree to the following terms and conditions in this Patient Consent, Disclosure, and Assignment of Benefits ('Consent and Assignment'):
1) Consent to Treatment: I consent to transport and treatment by Provider including the administration of blood products and any other treatment deemed necessary in the judgment of the medical crew (the 'Services').
2) Assignment of Insurance Benefit: I hereby assign to Provider the amounts to which I am entitled from any applicable health insurance or other benefit plans, including but not limited to Medicare, Medicaid and any commercial plan (collectively, 'Benefit Plans') as a result of my transport and treatment by Provider until Provider has been fully paid. I hereby authorize Provider to submit claims, on my behalf, to the Benefit Plan (or its administrator). I also hereby instruct my Benefit Plan (or its administrator) to pay Provider directly for the Services rendered to me. I acknowledge that my assignment to Provider of these benefits does not relieve me of my responsibility to pay the total amount due to Provider for the Services, and I agree to pay such amount to Provider.
I irrevocably and perpetually assign and convey to Provider any and all right, title, and interest, in and to, all legal, regulatory, statutory, equitable, declaratory, injunctive, civil enforcement, common law, contractual, beneficial, or administrative claims, causes of action, choses in action, rights, or benefits (both known and unknown) (the 'Claims') that have arisen or may arise (in the past, present and/or future), under any Benefit Plan or contract (including, but not limited to, an insurance contract) to which I am a party or under which I am otherwise entitled to rights or benefits, and any statute, governmental regulation, common law, judicial or administrative opinion or order, right in equity, or fiduciary or other owed to me, that relates to, provides or may provide for, authorizes or may authorize payment for, or otherwise arises from the medical services I received from the Provider. This assignment and conveyance includes any and all rights to pursue or enforce the Claims, including but not limited to the right to seek prospective injunctive or declaratory relief. This assignment and conveyance constitutes an express and knowing assignment and conveyance of an ERISA breach of fiduciary duty claims and other equitable, legal and/or administrative claims, including but not limited to claims brought under 29 U.S.C. § 1132(a)(1) and 29 U.S.C. § 1132(a)(3).
3) Authorization to Release Information: I hereby authorize Provider to: (1) release any information necessary to process my claim to my Benefit Plan (or its administrator); or (2) Process Benefit Plan claims generated in the course of examination or treatment by Provider.
This Consent and Assignment will remain in effect until revoked by me in writing.
4) Authorized Representative: I hereby designate and authorize Provider, to the full extent permissible under law and under any applicable Benefit Plan, including any ERISA plan, to act as my Authorized Representative and to exercise: (1) the right and ability to act on my behalf in connection with any claim, right or cause of action that I may have under such Benefit Plan; and (2) the right and ability to act on my behalf to pursue such claim, right, or cause of action in connection with said Benefit Plan (including but not limited to, the right to act on my behalf in respect to a Benefit Plan governed by the provisions of ERISA as provided in 29 C.F.R. 425603031(b)(4)) with respect to any healthcare expense incurred as a result of the Services I received from Provider and, to the extent permissible under the law, to claim on my behalf such benefits, claims, or reimbursement, and any other applicable remedy, including fines. A photocopy of this Consent and Assignment shall be as effective and valid as the original.
5) Insurance Certification and Authorization: I accept responsibility for ensuring that all certifications or authorizations required by Medicare, Medicaid or any other Benefit Plans have been obtained. I recognize that I am responsible for any balance not paid by my Benefit Plan for any reason. I agree to fully cooperate with Provider in contesting any Benefit Plan denial with respect to the Services including executing any documents necessary to authorize Provider to contest any Benefit Plan denial.
6) Guarantee of Payment and Assignment of Benefits: I agree to pay Provider's charges for the Services, including but not limited to any co-payments, deductibles, or other expenses that are not covered by any Benefit Plan. All charges shall be due and payable on receipt of invoice. Unpaid accounts shall bear interest at the rate of 12% per annum. Up to the full amount of the charges for the Services and any attorney's fees and costs related to the recovery of same, I assign and transfer to Provider all my rights in and to: (a) all insurance benefits and other Benefit Plans (whether such insurance or Benefit Plans are owed by me or not) payable as a result of the injury or medical condition that necessitated the Services; (b) any and all proceeds paid or payable to me or on my behalf from any settlement, judgment or other award which is obtained as a result of the medical condition necessitating the Services; (c) any causes of action that may be assigned according to applicable State law, which I now have or may have in the future against any person or entity arising directly or indirectly from the medical condition which necessitated the Services. In the event any such proceeds are paid directly to me, I agree to pay them promptly to Provider to the extent of any unpaid charges.
7) Release of Liability for Personal Valuables: I understand and agree that Provider is not responsible for personal belongings brought into the medical transport, including, but not limited to, clothing, personal hygiene products, toiletries, dentures, glasses, prosthetic devices such as hearing aids, artificial limbs, medical assist devices, wallets, purses, credit cards, jewelry and money.
8) Acknowledgment of Receipt of Notice of Privacy Practices: I acknowledge receipt of Provider's Notice of Privacy Practices ('NPP'), which contains additional information about the use of my PHI. The NPP is also available on Provider's website (http://www.phiairmedical.com).
9) Release of Police Reports: I appoint Provider as my attorney in fact under applicable State law for obtaining police reports and other data related to the accident or incident for which Services were provided.
10) Attorney's Fees: If Provider is required to bring any action at law or equity to enforce the above terms, Provider shall be entitled to recover reasonable attorney's fees, court costs, and any other costs of collection incurred.
11) Patient Acknowledgement: The undersigned patient or patient representative acknowledges that he/she has read and understands the above terms, and has had an opportunity to ask any questions, has received satisfactory answers thereto and freely and voluntarily consents to the terms hereof as evidenced by my signature below.
Patient's Signature: [Signature]
Print Name (required): [Name]
Date (required): [Date]
Patient's condition is such that he/she is physically or mentally incapable of signing then an authorized representative can sign:
Reason patient cannot sign: [Reason]
(Explanation required whenever patient does not or cannot sign)
Authorized Representative Signature: [Signature]
Printed name (legibly): [Name]
Please indicate the relationship of the authorized representative: the patient's legal guardian, a relative or other person who receives governmental benefits on the patient's behalf; a relative or other person who arranges for the patient's treatment or exercises other responsibility for his or her affairs; or Other:
Define: [Definition]
Crew Member's Signature: The undersigned crewmember attests that the patient is physically and/or mentally incapable of signing:
AND no authorized representative is available or willing to sign: ________ Printed Name (Required): ________
AND Facility Signature: The above-named patient was received by: ________ Printed name/discipline: ________
Date & Time of Sign over: Date: ________ Time: ________ Facility name and unit: ________
Signing of this form by personnel other than the patient or an authorized representative does not constitute acceptance of any financial responsibility.
Facility Medical Record/patient ID Number: [ID Number]
Rev date 12/15/2022

Timeline

Flight Paramedic

Allegiance Air 1

11.2025 - Current