Do Not Resuscitate Order - DNR or Advance Directive

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Description Do Not Resuscitate Form

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.

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Printable Dnr Form Other Form Names

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Is A Dnr An Advance Directive FAQ

The name and contact information of your healthcare agent/proxy. Answers to specific questions about your preferences for care if you become unable to speak for yourself. Names and signatures of individuals who witness your signing your advance directive, if required.

A breathing machine, CPR, and artificial nutrition and hydration are examples of life-sustaining treatments. Living willAn advance directive that tells what medical treatment a person does or doesn't want if he/she is not able to make his/her wishes known.

The living will. Durable power of attorney for health care/Medical power of attorney. POLST (Physician Orders for Life-Sustaining Treatment) Do not resuscitate (DNR) orders. Organ and tissue donation.

You can get the forms in a doctor's office, hospital, law office, state or local office for the aging, senior center, nursing home, or online. When you write your advance directive, think about the kinds of treatments that you do or don't want to receive if you get seriously hurt or ill.

A Do Not Resuscitate (DNR) order is another kind of advance directive. A DNR 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.)

You can use an advance directive form to make this request or tell your doctor that you don't want to be resuscitated. In this case, a DNR order is put in your medical record by your doctor. DNR orders are accepted by doctors and hospitals in all states.

Talk to your agent. Talk to the person or persons you want to make decisions for you so they: Write your personal directive. You have 2 options: Sign it. You and a witness have to sign the personal directive to make it a legal document. Give out copies.

The living will.Durable power of attorney for health care/Medical power of attorney.POLST (Physician Orders for Life-Sustaining Treatment)Do not resuscitate (DNR) orders.Organ and tissue donation.

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Do Not Resuscitate Order - DNR or Advance Directive