Get the free Revocation of Do-Not-Resuscitate Order

This document serves as a formal revocation of a previously executed Do-Not-Resuscitate Order by the Declarant, allowing them to communicate their intent to revoke such order as per Michigan law.

How to fill out revocation of do-not-resuscitate order

How to fill out Revocation of Do-Not-Resuscitate Order

1. Obtain a copy of the current Do-Not-Resuscitate (DNR) order.
2. Review your local laws and regulations regarding DNR revocation.
3. Fill out the Revocation of Do-Not-Resuscitate Order form, ensuring you include all required information.
4. Clearly state your intention to revoke the DNR order.
5. Sign and date the form in the presence of a witness or notary if required.
6. Distribute copies of the signed revocation to your healthcare provider and keep a copy for your records.

Who needs Revocation of Do-Not-Resuscitate Order?

1. Patients who wish to change their resuscitation status.
2. Individuals who have recently experienced a change in health and want to ensure their wishes are current.
3. Family members or legal representatives acting on behalf of patients who wish to revoke their DNR.

This form is a revocation of Form MI-P009 (Do-Not-Resuscitate Order).

People Also Ask about

Are DNRs legally binding?

If you're a medical provider, and you knew the patient had a valid DNR, and you still performed CPR in clear violation of that DNR, you will have committed battery. You may be held liable should the patient or the patient's next-of-kin wish to pursue the matter.

Who has the power to revoke a DNR?

A DNR order can only be revoked by you, a medical professional, or a healthcare agent, so it is important to name a trusted person as your healthcare agent.

Can a DNR order be reversed?

Can I reverse my DNR orders? Yes. Your DNR orders are in place for as long as you wish them to be; you need only to destroy them if you wish to stop them. You should also contact your doctor's office and family if you do so.

Are DNRs legally binding?

Limited Chance of Survival: The main drawback of a DNR order is that it limits the chances of survival in the event of a potentially reversible condition. While CPR and resuscitation efforts are not always successful, there are situations where they could save a life.

How to rescind a DNR order?

You might have also heard that DNR orders are difficult to revoke. This is not true; you can change your mind about the DNR order at any time, verbally or in writing. Even if you are in an emergency situation, you can tell EMTs or any healthcare provider that they should disregard the existing DNR order.

How binding is a DNR?

Before it is legally binding, the DNR must be signed by a physician as well as notarized by a notary public. Once these steps are completed, your document can be recognized by the state. A properly completed advance directive or DNR form can then be given to all parties, including MedicAlert Foundation.

Can a DNR order be revoked?

Yes, a DNR order can be revoked at any time by the patient or their authorized healthcare proxy. To revoke the order, inform your physician or healthcare provider and destroy any related documents or bracelets. Notify caregivers and medical professionals to ensure everyone is aware of the change.

For pdfFiller’s FAQs

What is Revocation of Do-Not-Resuscitate Order?

The Revocation of Do-Not-Resuscitate (DNR) Order is a formal document indicating that a previously established directive not to perform cardiopulmonary resuscitation (CPR) on the patient is being canceled or nullified.

Who is required to file Revocation of Do-Not-Resuscitate Order?

Typically, the patient themselves or their legal representative is required to file the Revocation of Do-Not-Resuscitate Order.

How to fill out Revocation of Do-Not-Resuscitate Order?

To fill out the Revocation of Do-Not-Resuscitate Order, the individual must provide their name, date, and signature, and may also need to indicate the details of the original DNR order they are revoking.

What is the purpose of Revocation of Do-Not-Resuscitate Order?

The purpose of the Revocation of Do-Not-Resuscitate Order is to ensure that medical personnel are aware that the previously stated wishes against resuscitation are no longer applicable and to uphold the patient's current healthcare preferences.

What information must be reported on Revocation of Do-Not-Resuscitate Order?

The information that must be reported on the Revocation of Do-Not-Resuscitate Order typically includes the patient's name, the date of revocation, a statement indicating the revocation of the prior DNR order, and the signature of the person revoking the order.