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The document is a Prehospital Medical Care Directive, commonly known as a Do Not Resuscitate (DNR) order, which instructs emergency medical personnel not to perform resuscitation measures in the event of cardiac or respiratory arrest. It must be signed by the patient and their doctor, and it requires specific formatting on an orange background to be valid under Arizona law. The form includes sections for personal information, physician details, and signatures from both the healthcare provider and a witness.

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How do you initiate a DNR?

How is a DNR Order Created? If you decide you want a DNR order, tell your provider and health care team what you want. Your provider must follow your wishes, or: Your provider may transfer your care to a provider who will carry out your wishes.

What are the requirements to be a DNR?

The requirements for creating a DNR vary from state to state. In California, a DNR order must include the patients name and the date of the order, and must be signed by you (or your healthcare agent) and your physician. The DNR will be entered into your medical records.

How to fill out a do not resuscitate form?

How do I fill this out? To fill out the Do Not Resuscitate Order form, you will need to provide detailed personal information about the patient. Ensure that all relevant medical information and consents are included as required by state law. Once completed, make sure to have the form signed by the attending physician.

What is required for a DNR order to be valid?

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

How do you put a do not resuscitate order?

Patients and/or their families/surrogate may request a DNR order from the patients physician. The NJ Outof-Hospital DNR form is enclosed (pages 13-14) for your use or may be obtained from New Jersey Health Decisions by calling (973) 857-5552 (an administrative fee of $5.00 will be charged by NJHD).

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What is the protocol for do not resuscitate?

The DNR order informs healthcare providers not to perform CPR if a persons heart stops beating or their breathing stops. When you have a DNR, it becomes part of your medical chart. Sometimes, a DNR order is called a do-not-attempt-resuscitation order or an allow-natural-death (AND) order.

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