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PAINTED 0412812008 FORM APPROVED DEPARTMENT OF HEALTH AND HUMAN SERVICES STATEMENT OF Official:NCIS AND PI.AN OF CORRECTION (X1) PROVIDERISUPPUEflICLiA IDL:Notification NUMBER (x:!!) DATE (X2)

How to fill out a 44 - doh

How to Fill Out a 44 - DOH:

1. Determine the purpose of the 44 – DOH form. The 44 – DOH form, also known as the Notification of Do Not Resuscitate (DNR) Order, is used to communicate a patient's decision to healthcare providers regarding their preference for resuscitative efforts in case of cardiac or respiratory arrest. It is important to understand the purpose of this form before proceeding to fill it out.
2. Obtain the official 44 – DOH form. The 44 – DOH form is typically available at healthcare facilities, hospitals, or from the Department of Health in your respective state. You can contact your healthcare provider or search online to find the official form.
3. Gather the necessary information. Before filling out the form, you will need certain information. This may include the patient's full name, date of birth, address, contact information, and the name and contact details of their healthcare proxy or designated representative (if applicable).
4. Read the instructions carefully. The 44 – DOH form comes with instructions that guide you through the process. It is crucial to read and understand these instructions to ensure accurate completion of the form.
5. Fill out the patient's information. Start by entering the patient's full legal name, including their first name, middle initial (if applicable), and last name. Provide their complete date of birth, including the month, day, and year. In the respective fields, enter the patient's address and contact information.
6. Specify the patient's designated representative (if applicable). If the patient has designated a healthcare proxy or representative to make medical decisions on their behalf, provide the representative's full name, address, and contact number in the designated sections.
7. Indicate the patient's decision regarding resuscitative efforts. This section is crucial for conveying the patient's preference in case of cardiac or respiratory arrest. The 44 – DOH form typically offers different options, such as Full Code, DNR Comfort Measures, or DNR Comfort Measures Only. Choose the appropriate option based on the patient's wishes.
8. Sign and date the form. The patient or their designated representative, if applicable, should sign and date the form. This signature indicates their understanding and agreement with the provided information.

Who Needs a 44 - DOH?

1. Individuals with a terminal illness or advanced medical condition. Patients who have been diagnosed with a terminal illness or have an advanced medical condition may consider filling out a 44 – DOH form to communicate their end-of-life preferences regarding resuscitative efforts.
2. Elderly individuals with significant health issues. Aging individuals who wish to express their preferences for resuscitative efforts can benefit from completing a 44 – DOH form. This ensures that their wishes are known and followed should a cardiac or respiratory arrest occur.
3. Patients who want to avoid unnecessary medical interventions. Some individuals may prefer a more natural and comfortable end-of-life experience and choose to opt-out of aggressive resuscitative measures. A 44 – DOH form allows them to express their desire for comfort measures rather than extensive life-saving procedures.

Remember, it is essential to consult with a healthcare professional, such as a doctor or nurse, when considering or filling out a 44 – DOH form. They can provide guidance, answer any questions, and ensure that the form aligns with your specific medical situation and legal requirements.

For pdfFiller’s FAQs

What is a 44-doh?

A 44-doh is a form used to report financial information to the government.

Who is required to file a 44-doh?

Any individual or organization that meets the filing requirements set by the government.

How to fill out a 44-doh?

You can fill out a 44-doh form by providing the required financial information accurately and submitting it to the designated authority.

What is the purpose of a 44-doh?

The purpose of a 44-doh is to ensure transparency and compliance with financial regulations.

What information must be reported on a 44-doh?

The information reported on a 44-doh typically includes details of income, expenses, assets, and liabilities.

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