Get Ks Pre-hospital Do Not Resuscitate (dnr) Request Form
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How to fill out the KS Pre-Hospital Do Not Resuscitate (DNR) Request Form online
This guide provides clear and detailed instructions on how to complete the KS Pre-Hospital Do Not Resuscitate (DNR) Request Form online. Following these steps will help ensure that your preferences regarding emergency medical care are accurately documented.
Follow the steps to complete the online form successfully.
- Click the ‘Get Form’ button to access the KS Pre-Hospital Do Not Resuscitate (DNR) Request Form. This will open the form in an interactive format, allowing you to complete the necessary fields.
- In the first section, fill in your name on the line provided. Clearly state your request for limited emergency care.
- Read and acknowledge the explanation of what DNR means. Confirm your understanding that no medical procedures will be initiated to restart heart or breathing functions if either stops.
- Provide assurance that this decision does not limit your access to other emergency medical care from pre-hospital care providers or physicians prior to your death.
- Indicate your right to revoke this directive at any time, and give consent for your directives to be communicated to relevant healthcare providers.
- Sign and date the form at the designated lines. Ensure your signature is clear to validate your intention regarding the DNR request.
- A witness is required to sign the form. Have a trusted individual read and confirm your directive before they sign and date it as well.
- The attending physician must sign the form to affirm that the directive is medically appropriate. If you are a member of a religious group that provides care through spiritual means, their signature may not be necessary.
- Fill in the facility or agency name and address if applicable, providing additional context for your healthcare directives.
- If you wish to revoke your DNR directive, complete the revocation section by signing and dating it.
Complete the KS Pre-Hospital Do Not Resuscitate (DNR) Request Form online today to ensure your medical preferences are respected.
Initiating a DNR involves discussing the patient's healthcare wishes with their medical provider. After evaluating the patient's condition, you can fill out a KS Pre-Hospital Do Not Resuscitate (DNR) Request Form together with the provider, ensuring that all legal requirements are met. Proper communication about the form's existence and the patient's intentions is vital to ensure everyone is aligned. This step provides clarity and direction to medical teams in case of emergencies.
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