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Do Not
OrderResuscitateA Do Not Resuscitate (DNR) Order
is a written order by a
physician telling healthcare
providers to not attempt to
revive a patient in the case of
a cardiac or respiratory arrest.
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How to fill out a do not resuscitate

How to fill out a do not resuscitate
01
To fill out a do not resuscitate (DNR) form, follow these steps:
02
Start by obtaining the appropriate DNR form for your jurisdiction. Each jurisdiction may have different requirements and forms, so make sure to use the correct one.
03
Read the instructions provided with the form carefully. These instructions will guide you on how to properly fill out the form.
04
Provide the necessary personal information, such as your name, date of birth, and contact information.
05
Indicate your preferences regarding resuscitation. Specify whether you want to be resuscitated or not in case of cardiac or respiratory arrest.
06
If you have specific instructions or preferences regarding certain medical interventions, such as intubation or defibrillation, include them on the form.
07
Sign and date the form to make it legally valid. Depending on the jurisdiction, you may also need witnesses or notary signatures for the form.
08
Once completed, keep a copy of the form for yourself and distribute copies to your healthcare provider, family members, and any other relevant individuals or institutions.
09
Remember to regularly review and update your DNR form as your preferences or medical condition may change over time.
Who needs a do not resuscitate?
01
A do not resuscitate (DNR) order is typically for individuals who have a terminal illness, advanced age, or a significant medical condition that may make resuscitation efforts futile or against their wishes.
02
Individuals who have discussed their preferences with their healthcare provider and determined that they do not desire resuscitation in case of cardiac or respiratory arrest may also opt for a DNR order.
03
The decision to have a DNR order is deeply personal and should be made in consultation with a healthcare provider and loved ones.
04
It is important to note that DNR orders are not suitable for everyone and depend on an individual's specific medical circumstances and preferences.
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What is a do not resuscitate?
A do not resuscitate (DNR) order is a medical directive instructing healthcare providers not to perform cardiopulmonary resuscitation (CPR) in case of cardiac or respiratory arrest.
Who is required to file a do not resuscitate?
A DNR order can be requested by a competent adult patient, or by their legally authorized representative.
How to fill out a do not resuscitate?
A DNR form must be filled out and signed by a healthcare provider, patient, or their representative, in accordance with state-specific guidelines.
What is the purpose of a do not resuscitate?
The purpose of a DNR order is to honor a patient's wishes to avoid unwanted or futile life-saving measures in certain medical situations.
What information must be reported on a do not resuscitate?
A DNR order typically includes the patient's name, date of birth, signature, and the date the order was issued.
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