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COUNTY OF SACRAMENTO EMERGENCY MEDICAL SERVICES AGENCYDocument #2085.17PROGRAM DOCUMENT:Draft Date:11/04/99Last Approved Date:12/27/16Effective Date:06/01/19Next Review Date:03/14/21Do Not Resuscitate
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How to fill out dnr - department of
How to fill out dnr - department of
01
To fill out the DNR (Do Not Resuscitate) form, follow these steps:
02
Obtain a copy of the DNR form from your local Department of Health or hospital.
03
Read the instructions on the form carefully to understand the requirements and implications.
04
Fill in your personal information accurately, including your full name, date of birth, and contact details.
05
Provide information about your healthcare proxy or agent, if applicable.
06
Indicate your choice regarding resuscitation by checking the appropriate box. Options usually include Full Code, Do Not Intubate, and Do Not Resuscitate.
07
Sign and date the form in the designated areas. Some forms may require a witness or healthcare professional's signature as well.
08
Make copies of the completed form for yourself, your healthcare proxy, and your primary care physician.
09
Store the original form in a safe but easily accessible place, such as a drawer or a filing cabinet.
10
Notify your family members, healthcare providers, and other relevant individuals about your decision and provide them with a copy of the DNR form.
11
Review and update the DNR form periodically to ensure it reflects your current wishes.
Who needs dnr - department of?
01
The DNR (Do Not Resuscitate) form is intended for individuals who wish to express their desire to forego certain life-sustaining treatments in the event of cardiac or respiratory arrest. The form is typically recommended for people with serious, advanced illnesses, elderly individuals, those in hospice or palliative care, and individuals who have discussed end-of-life care options with their healthcare providers. It is important to consult with a medical professional or the local Department of Health to determine if a DNR form is appropriate for your specific circumstances.
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