Do not resuscitate form 2025

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The nonhospital DNR form is very short, not even a full page. It just includes the patients name, date of birth, a statement indicating, do not resuscitate the person named above, and then signatures and information for the physician, nurse practitioner, or physician assistant completing the form.
You can use an advance directive form or tell your doctor that you dont want to be resuscitated. Your doctor will put the DNR order in your medical chart.
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 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.
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.
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Most DNR forms do not need to be notarized, although they can be. Typically, two adult witnesses are required to watch you sign the order, and then add their own signatures to attest that you were sound of mind. However, you can replace these two witness signatures by having your DNR Form signed by a notary.
Download, Complete, and Sign. The DNR form should be printed and signed by both the doctor and patient in the presence of two witnesses.

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