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Click ‘Get Form’ to open the DO NOT RESUSCITATE ORDER in our editor.
Begin by entering the patient’s full legal name and date of birth in the designated fields at the top of the form.
In the Patient’s (or Authorized Person’s) Statement section, indicate your understanding of your right to refuse CPR. Sign and date this section as either the patient or an authorized person.
If you are signing on behalf of the patient, specify your relationship by checking the appropriate box (principal, surrogate, proxy, etc.) and provide your printed name.
Next, in the Health Care Provider’s Statement section, enter the provider's full legal name and license number. The provider must sign and date this section as well.
Ensure all information is accurate before saving or printing. Remember that a copy printed on yellow paper is valid as the original.

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Can a family member override a DNR in Florida?

If your doctor has already written a DNR order at your request, your family may not override it. You may have named someone to speak for you, such as a health care agent. If so, this person or a legal guardian can agree to a DNR order for you.

How do I set up a do not resuscitate order?

Your doctor may complete a DNACPR form to indicate this and put it in your medical records. If you wish to make your refusal of CPR legally binding for when in the future you are unable to make this decision, then you should write an Advance Decision to Refuse Treatment (ADRT).

How does a DNR work in Florida?

The doctor can only write a DNR order after consulting with you (the patient), your appointed representative, or a member of your family. The order, once executed, instructs medical providers to refrain from resuscitating the named patient.

What are the requirements for a DNR in Florida?

Both the patient (or their surrogate, durable power of attorney, etc) AND the patients doctor must sign. The only other DNR requirement is: yellow paper.

What does the Florida DNR do?

Unlike these other forms of healthcare directives, though, DNRs are very straightforward: they tell doctors not to resuscitate the patient. CPR and other forms of resuscitation are automatically performed to save a persons life in the absence of an appropriate DNR order.

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