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Doh 5003 form-2026
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- Click ‘Get Form’ to open the DOH-5003 form in the editor.
- Begin with Section A, where you will select either 'CPR Order' or 'DNR Order'. Ensure only one box is checked to indicate the patient's resuscitation preferences.
- Move to Section B and indicate who consented to the resuscitation instructions. Fill in the name of the decision-maker and ensure their signature is included.
- In Section C, a physician must sign and print their name, confirming the orders in Sections A and B are valid.
- Proceed to Section D to check any advance directives that apply, such as Health Care Proxy or Living Will.
- In Section E, specify orders for other life-sustaining treatments. Check appropriate options regarding intubation, hospitalization, and nutrition.
- Finally, review all sections for accuracy before saving or printing your completed form.
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