Alabama do not resuscitate dnr form 2026

The document is an Alabama Portable Physician Do Not Attempt Resuscitation (DNAR) Order, which allows patients or their representatives to refuse resuscitative measures in the event of cardiopulmonary cessation. It includes sections for patient consent, provisions for incompetent patients, health care proxy or attorney-in-fact consent, surrogate consent, and physician authorization. The order emphasizes the importance of comfort care and outlines the necessary signatures required for validity.

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Click ‘Get Form’ to open the Alabama Do Not Resuscitate DNR form in our editor.
Begin by entering the patient/resident's full name and date of birth in the designated fields at the top of the form.
In Section I, if you are the patient/resident, sign and date to indicate your consent for withholding resuscitative measures.
If applicable, proceed to Section II. A health care provider or facility representative must sign and date this section if the patient is incompetent.
For Section III, if you are a health care proxy or attorney-in-fact, provide your signature and print your name along with the date.
In Section IV, if you are a surrogate decision-maker, complete this section by signing and printing your name with the date.
Finally, in Section V, a physician must sign and print their name along with the date to authorize the order.

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