Dnr Form For Texas - Do Not Resuscitate Order - DNR or Advance Directive

State:
Multi-State
Control #:
US-02091BG
Format:
Word
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Description

A do not resuscitate (DNR) order is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. Unless given other instructions, hospital staff will try to help all patients whose heart has stopped or who have stopped breathing. A DNR order is put in your medical chart by your doctor. DNR orders are accepted by doctors and hospitals in all states.


This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.

The Do Not Resuscitate (DNR) form for Texas is a legal document that allows individuals to express their wishes regarding resuscitation in the event of a medical emergency. It is an important aspect of advance care planning and addresses the desire to avoid aggressive life-saving measures when the individual's heart or breathing stops. The DNR form, also known as the Out-of-Hospital Do-Not-Resuscitate (OOH DNR) form, specifies the individual's preference regarding cardiopulmonary resuscitation (CPR) when they are outside a healthcare facility. This form is primarily intended for people who are approaching the end of life or have a terminal condition. It serves as a guide for emergency medical responders and helps to honor the individual's wishes for a natural death without attempting life-saving interventions. In addition to the OOH DNR form, Texas offers different types of DNR forms to cater to various settings and situations. These include: 1. In-hospital DNR: This form is specifically for individuals who are currently hospitalized. It is designed to indicate the individual's preference for the withholding or withdrawal of CPR within the hospital setting. 2. Comfort One DNR: This form is intended for individuals residing in long-term care facilities, such as nursing homes or assisted living facilities. It allows individuals to express their preference for comfort-focused care rather than aggressive life-saving measures. 3. EMS-DNR form: The EMS (Emergency Medical Services) DNR form is for individuals who wish for EMS providers to withhold or withdraw resuscitation measures outside a healthcare facility. This differs from the OOH DNR form as it pertains to cases where EMS is present on the scene. These forms are legally binding documents that should be completed under the guidance of a healthcare professional. It is vital to discuss the options with a physician or other trusted healthcare provider to ensure the individual's wishes are accurately documented and their end-of-life care preferences are respected. By understanding and completing the appropriate DNR form for Texas, individuals have the opportunity to guide their medical care when they are unable to communicate their wishes in a medical emergency, promoting a sense of autonomy and peace of mind during critical situations.

Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.
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FAQ

Does the form have to be notarized? A notary public can witness the signature of the person filling out the form in lieu of two witnesses. If two witnesses are present, the form does not need to be notarized.

(1) An intact, unaltered, easily identifiable plastic identification OOH DNR bracelet, with the word "Texas" (or a representation of the geographical shape of Texas and the word "STOP" imposed over the shape) and the words "Do Not Resuscitate," shall be honored by qualified EMS personnel in lieu of an original OOH DNR ...

The DNR must be signed by the patient or by the patient's legally recognized health care decision maker if the patient is unable to make or communicate informed health care decisions.

A DNR is a request not to have CPR if your heart stops or if you stop breathing. 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.

The Texas Out-of-Hospital DNR form requires your signature, the signatures of your doctor, and the signatures of two competent adult witnesses or a notary instead of the witnesses. If you use two witnesses, rather than a notary, one of the two witnesses cannot be: Your relative (by blood or marriage)

More info

Texas Health and Human Services Home Texas Health and Human Services. All persons who have signed above must sign below, acknowledging that this document has been properly completed.If you have a valid Out-of-Hospital DNR, EMS will not use any of the five procedures listed in the Out-of-Hospital DNR form to revive you. You can fill out a Texas Out-of-Hospital DNR form if you want to. Adjusting documents with our extensive and user-friendly PDF editor is easy. Attached is a color coded DNR form. How does a competent person who cannot sign his or her name fill out a DNR form under Section A? You can use an advance directive form or tell your doctor that you don't want to be resuscitated. Texas Department of State Health Services. Health Care Quality Section.

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Dnr Form For Texas