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The Prehospital Medical Care Directive, also known as a Do Not Resuscitate (DNR) order, is a legal document that 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 a witness or notary, and it requires specific formatting on orange paper to be valid under Arizona law. The document emphasizes the importance of comfort care and provides guidelines for designating a Health Care Power of Attorney.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information. Fill in your printed name, date of birth, sex, race, eye color, and hair color in the designated fields.
Sign the form where indicated. Ensure that you also include the date of your signature.
If applicable, provide details about your Health Care Power of Attorney. Include their printed name and signature.
Next, fill in information about your doctor and hospice program if you are in hospice care. Include their name and telephone number.
Finally, ensure that either a witness or notary public signs the document. Remember, do not have both sign.

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Make sure you display this form as visibly as possible for first ... 2025

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How to use or fill out the Prehospital Medical Care Directive with our platform

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Can I type my electronic signature on my how to make google form public but not editable?

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How to make Google Form available to everyone but not editable?

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Make sure you display this form as visibly as possible for first ... 2025

Here's how it works

How to use or fill out the Prehospital Medical Care Directive with our platform

See more make sure you display this form as visibly as possible for first ... versions

Complete this form in 5 minutes or less

Got questions?

Can I type my electronic signature on my how to make google form public but not editable?

What internet browser do I need to edit make sure you display this form as visibly as possible for first ... online?

How to make Google Form available to everyone but not editable?

How do I share a Google Form with non Gmail users?

How do I add a form to PowerApps?

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Why is my form not showing in Power Apps?

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