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How do I complete a DNR?

If you or your loved one are in the hospital, please speak with your medical providers (e.g., nurse, doctor, physician assistant, nurse practitioner, etc.) about a DNR.

If you are not in the hospital, a nonhospital DNR can be completed. This order must be signed by a doctor, nurse practitioner, or physician assistant. It should also be easily located. If an ambulance comes to your home and they do not see a DNR, they will likely try to resuscitate you, no matter what your family members tell them. If someone has a DNR and wants to increase the chances it will be followed, we advise them to post it on the inside wall next to their front door, so that if an ambulance comes, the technicians will see it. To be clear, this form should only be completed if you do not want to be resuscitated.

The nonhospital DNR form is very short, not even a full page. It just includes the patient’s name, date of birth, a statement indicating, “do not resuscitate the person named above,” and then signatures and information for the physician, nurse practitioner, or physician assistant completing the form. The form must be signed by a medical provider, as it is a medical order. It is the responsibility of the physician/nurse practitioner to determine, at least every 90 days, whether this order continues to be appropriate, and to indicate this by a note in the patient’s medical chart. Under the law, this order should be considered valid unless it is known that it has been revoked.

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