Get the free Do Not Resuscitate (DNR) Form 3462 (pdf)

Emergency Medical Services Do Not Resuscitate OrderSOUTH CAROLINA EMERGENCY MEDICAL SERVICESRESUSCITATEDO NOT RESUSCITATE ORDERNOTICE TO EMS PERSONNEL This notice is to inform all emergency medical

How to fill out do not resuscitate dnr

How to fill out a do not resuscitate (DNR) form:

1. Begin by obtaining the DNR form, which can typically be obtained from a healthcare provider or hospital. Some states also provide downloadable forms from their websites.
2. Carefully read and understand the instructions on the form. Each form may have specific requirements and instructions for completion.
3. Fill in the necessary personal information, including your full name, date of birth, address, and contact information. Ensure that the information provided is accurate and up to date.
4. Indicate your healthcare provider's name and contact information. This is important as it helps the medical team communicate with your designated healthcare provider in case of an emergency.
5. Consider appointing a healthcare proxy if the form allows. A healthcare proxy is someone you trust to make medical decisions on your behalf if you become unable to do so.
6. Specify your treatment preferences by choosing the appropriate options provided on the form. This may include indicating whether you want cardiac resuscitation, intubation, or other life-saving measures.
7. If there are any specific instructions or requests you have, such as religious or cultural considerations, make sure to include them in the designated section.
8. Check if the form requires your signature and date. If so, ensure that you sign and date the form as required. Some forms may require a witness or notary to validate the document.
9. Keep the original form in a safe and easily accessible place. Inform your loved ones or healthcare provider about the existence and location of the DNR form.
10. Regularly review and update your DNR form as needed. Changes in your medical condition or preferences may require updating the form to ensure it accurately reflects your wishes.

Who needs a do not resuscitate (DNR) form?

1. Individuals with terminal or advanced illness who prefer not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
2. Patients who have discussed their end-of-life wishes with their healthcare provider and have made an informed decision to decline resuscitation.
3. People who have a debilitating illness or declining health and want to ensure their wishes regarding resuscitation are respected.
4. Individuals nearing the end of life who wish to prioritize comfort and a natural approach to death rather than invasive life-saving measures.
5. It is essential to have open conversations with healthcare providers, family members, and loved ones about your wishes to ensure they are aware and can support your decision.

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