Do Not Intubate Form - lincoln ne 2026

1. Click ‘Get Form’ to open the Do Not Intubate Form in the editor.
2. Begin by entering your name in the designated field at the top of the form, ensuring it matches your identification documents.
3. In the section regarding your medical illness, provide a brief description of your diagnosis as discussed with your physician.
4. Select the checkbox for 'DO NOT INTUBATE' to indicate your wishes regarding mechanical ventilation. Make sure you understand this means no tube will be placed in your airway.
5. If applicable, check 'DO NOT RESUSCITATE (DNR)' to specify that no artificial resuscitation should be initiated if your heart stops or breathing is inadequate.
6. Sign and date the form where indicated, ensuring that either you or your Durable Power of Attorney for Health Care completes this step.
7. Fill in your address and ensure a witness signs the document as required.
8. Finally, have your physician complete their section, including their signature and date, confirming they have discussed this order with you.

Start using our platform today to easily fill out and manage your Do Not Intubate Form for free!