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Click ‘Get Form’ to open the Out of Hospital Do Not Resuscitate Declaration in the editor.
Begin by filling in the date on which you are making the declaration. This is crucial for the document's validity.
In the designated area, enter your full name, ensuring it matches your identification documents.
Clearly state your medical condition as certified by your attending physician. This section is vital for establishing your eligibility for a DNR order.
Indicate your wishes regarding resuscitation procedures if you experience cardiac or pulmonary failure outside of a hospital setting.
Sign and print your name at the bottom of the declaration, confirming that you understand its implications.
Have two witnesses sign and print their names, ensuring they meet the criteria outlined in the document.
Finally, if applicable, have your attending physician complete and sign the DNR order section, including their medical license number.
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TWO-LETTER STATE AND TERRITORY ABBREVIATIONS STATE(TERRITORY)STATE(TERRITORY) Idaho ID New Mexico Illinois IL New York Indiana IN North Carolina Iowa IA North Dakota15 more rows
What is the code in Indiana?
Standards State CodeState NameState Numeric Code AR Arkansas 05 CA California 06 CO Colorado 08 CT Connecticut 0954 more rows
What is Indianas state code?
The Indiana Code may be cited as IC.
What is the code for Indiana?
Free Resources for Indiana Statutory Research Indiana Code. Heres a quick access link to the Indiana Code. Indiana Constitution. Heres a quick access link to the Indiana Constitution; you can browse by Article. Findlaw. Findlaw is a website for non-attorneys who would like to learn more about laws across the country.
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