Printable Do Not Resuscitate Form
What is a printable Do Not Resuscitate form?
A printable Do Not Resuscitate (DNR) form is a legal document that informs medical professionals about an individual's decision not to receive cardiopulmonary resuscitation (CPR) or other life-saving measures in case of a medical emergency. It is typically signed by the patient or their legal representative and is recognized by healthcare providers as a legally binding request.
What are the types of printable Do Not Resuscitate form?
There are different types of printable Do Not Resuscitate forms available, including:
State-specific DNR forms: These forms comply with the specific regulations and requirements of each state.
Physician Orders for Life-Sustaining Treatment (POLST) forms: These forms provide a broader scope of instructions regarding the use of life-sustaining treatments beyond CPR.
Out-of-hospital DNR forms: These forms are specifically designed for individuals who do not wish to be resuscitated outside of a healthcare facility.
How to complete a printable Do Not Resuscitate form
Completing a printable Do Not Resuscitate form is a simple process. Here are the steps:
01
Obtain the appropriate form: Depending on your location and specific needs, obtain the correct printable Do Not Resuscitate form.
02
Read the instructions: Carefully read the instructions on the form to understand the requirements and process.
03
Fill in personal information: Provide your name, date of birth, and other required personal information.
04
Choose your instructions: Select the specific instructions you want regarding resuscitation and life-saving measures.
05
Sign the form: Sign the form to indicate your agreement and understanding.
06
Witness signatures: If required, have witnesses sign the form.
07
Share the form: Give copies of the completed form to your healthcare providers, family members, and anyone who needs to be aware of your wishes.
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Questions & answers
How do I write a DNR letter?
I, _________________________________________, request limited emergency care as herein described. I understand DNR means that if my heart stops beating or if I stop breathing, no medical procedure to restart breathing or heart functioning will be instituted.
How do I make myself DNR?
You can use an advance directive form or tell your doctor that you don't want to be resuscitated. Your doctor will put the DNR order in your medical chart. Doctors and hospitals in all states accept DNR orders. They do not have to be part of a living will or other advance directive.
Can you request a DNR?
If you decide you want a DNR order, tell your doctor and health care team what you want. Your doctor must follow your wishes, or: Your doctor may transfer your care to a doctor who will carry out your wishes.
How do you write a do-not-resuscitate order?
Any adult can request a DNR, including healthy adults. People most likely to use them are those who know in advance that their chance of surviving CPR is very low and/or they don't want to spend their last days on life support.
How do I get a DNR in Arkansas?
When submitted to a hospital, an individual can request this form through their physician. Alternatively, one could ask their physician ahead of time for a DNR form, which would alert emergency responders/personnel, paramedics, etc. of the individual's wishes.
Can a DNR be placed without consent?
Unfortunately, it is not necessary for a patient or their family to give their consent to a DNR. However, they should be involved in the decision-making process and ensure that the doctor has all of the relevant facts before making a decision.
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