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Click ‘Get Form’ to open the Download Uniform Do Not Resuscitate (DNR) Order form in the editor.
Begin by filling in the patient’s full name and birth date at the top of the form. This information is crucial for identifying the individual.
In the 'FULL CARDIOPULMONARY ARREST' section, select your preference regarding CPR by checking either 'Do Not Attempt Cardiopulmonary Resuscitation (CPR)' or leaving it unchecked if you wish to attempt CPR.
Next, move to the 'PRE-ARREST EMERGENCY' section. Choose one option regarding CPR during a pre-arrest situation by marking your choice clearly.
Provide any additional instructions in the space provided for further clarification of your wishes.
Ensure that you or your legal representative signs and dates the authorization section to validate the DNR order.
Two witnesses must sign and date their names in the designated area, confirming they witnessed your consent.
Finally, have your attending physician sign and date the form to complete it. Ensure all sections are filled accurately before saving or printing.

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