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Get KS Pre-Hospital Do Not Resuscitate (DNR) Request Form

No medical procedure to restart breathing or heart functioning will be instituted. I understand this decision will not prevent me from obtaining other emergency medical care by pre-hospital care providers or medical care directed by a physician prior to my death. I understand I may revoke this directive at any time. I give permission for this information to be given to the pre-hospital care providers, doctors, nurses or other health care personnel as necessary to implement this directive. I her.

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