Indianapolis Indiana Out of Hospital - Do not Resuscitate Declaration - DNR - Statutory Form

State:
Indiana
City:
Indianapolis
Control #:
IN-P022
Format:
Word; 
Rich Text
Instant download
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Public form

Description

This is a state specific form specifying your desires that, should you experience cardiac or pulmonary failure in a location other than an acute care hospital or a health facility, cardiopulmonary resuscitation procedures be withheld or withdrawn and that you be permitted to die naturally.

The Indianapolis Indiana Out of Hospital — Do not Resuscitate (DNRDeclarationio— - Statutory Form is a legal document that allows an individual to make an advance decision regarding their medical treatment in the event of a cardiac or respiratory arrest occurring outside the hospital setting. This declaration is recognized and governed by the laws of the state of Indiana. The purpose of this form is to inform medical professionals and emergency responders of the individual's desire to withhold cardiopulmonary resuscitation (CPR), advanced airway management, and other resuscitation measures in case of a life-threatening situation. By completing this form, the individual is stating their explicit wish not to receive such interventions or procedures. The Indianapolis Indiana Out of Hospital DNR Declaration — Statutory Form contains several key elements. It includes the person's full legal name, date of birth, and address. The individual must also provide the contact information for their attending physician or nurse practitioner, who will confirm the document's validity and ensure it is consistent with the patient's current medical condition. There are no specific sub-types or variations of this form mentioned in the public domain. However, it is important to note that this form is specific to out-of-hospital situations. In Indiana, there may be other DNR forms applicable to hospital settings or cases where the declaration is made by a healthcare representative on behalf of the patient. When the form is completed, it should be signed and dated in the presence of two adult witnesses who are not related to the patient, do not stand to inherit any part of the patient's estate, and are not the patient's attending physician or nurse practitioner. The witnesses' names and addresses must also be provided on the form. Once the Indianapolis Indiana Out of Hospital DNR Declaration — Statutory Form is signed, it is important to distribute copies to relevant parties. These may include the patient's healthcare provider, family members, caregivers, and emergency services personnel. The form must be displayed prominently in the patient's residence so that it is easily accessible in the event of an emergency. It is worth noting that the DNR declaration is not applicable in cases of non-emergency medical care, routine medical treatment, or pain management. It solely applies to situations involving cardiac or respiratory arrest outside a hospital. By having a completed Indianapolis Indiana Out of Hospital DNR Declaration — Statutory Form, individuals can have peace of mind knowing that their preferences regarding resuscitation measures are documented and legally recognized.

The Indianapolis Indiana Out of Hospital — Do not Resuscitate (DNRDeclarationio— - Statutory Form is a legal document that allows an individual to make an advance decision regarding their medical treatment in the event of a cardiac or respiratory arrest occurring outside the hospital setting. This declaration is recognized and governed by the laws of the state of Indiana. The purpose of this form is to inform medical professionals and emergency responders of the individual's desire to withhold cardiopulmonary resuscitation (CPR), advanced airway management, and other resuscitation measures in case of a life-threatening situation. By completing this form, the individual is stating their explicit wish not to receive such interventions or procedures. The Indianapolis Indiana Out of Hospital DNR Declaration — Statutory Form contains several key elements. It includes the person's full legal name, date of birth, and address. The individual must also provide the contact information for their attending physician or nurse practitioner, who will confirm the document's validity and ensure it is consistent with the patient's current medical condition. There are no specific sub-types or variations of this form mentioned in the public domain. However, it is important to note that this form is specific to out-of-hospital situations. In Indiana, there may be other DNR forms applicable to hospital settings or cases where the declaration is made by a healthcare representative on behalf of the patient. When the form is completed, it should be signed and dated in the presence of two adult witnesses who are not related to the patient, do not stand to inherit any part of the patient's estate, and are not the patient's attending physician or nurse practitioner. The witnesses' names and addresses must also be provided on the form. Once the Indianapolis Indiana Out of Hospital DNR Declaration — Statutory Form is signed, it is important to distribute copies to relevant parties. These may include the patient's healthcare provider, family members, caregivers, and emergency services personnel. The form must be displayed prominently in the patient's residence so that it is easily accessible in the event of an emergency. It is worth noting that the DNR declaration is not applicable in cases of non-emergency medical care, routine medical treatment, or pain management. It solely applies to situations involving cardiac or respiratory arrest outside a hospital. By having a completed Indianapolis Indiana Out of Hospital DNR Declaration — Statutory Form, individuals can have peace of mind knowing that their preferences regarding resuscitation measures are documented and legally recognized.

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Indianapolis Indiana Out of Hospital - Do not Resuscitate Declaration - DNR - Statutory Form