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EMS DNR EMERGENCY MEDICAL SERVICES EMS / DO NOT RESUSCITATE DNR FORM Will your Patients wishes to avoid unwanted resuscitation be honored during a medical emergency outside of the hospital The EMS-Do Not Resuscitate DNR form developed by the EMS Bureau Epidemiology and Response Division of the New Mexico Department of Health instructs EMS personnel to forgo resuscitation attempts in the event of a patient s cardiopulmonary arrest. The form has 3 parts. One for your patient one for your patient s medical records and one for your patient to order an optional MedicAlert Medallion You may download FREE DNR Forms from nmems. EMS DNR EMERGENCY MEDICAL SERVICES EMS / DO NOT RESUSCITATE DNR FORM Will your Patients wishes to avoid unwanted resuscitation be honored during a medical emergency outside of the hospital The EMS-Do Not Resuscitate DNR form developed by the EMS Bureau Epidemiology and Response Division of the New Mexico Department of Health instructs EMS personnel to forgo resuscitation attempts in the event of a patient s cardiopulmonary arrest. The form has 3 parts. One for your patient one for your patient s medical records and one for your patient to order an optional MedicAlert Medallion You may download FREE DNR Forms from nmems. org For individual EMS-DNR forms or questions about the implementation of the EMSDo Not Resuscitate DNR program contact the EMS Bureau at 505-476-8200 ORDER FORM To order your forms send in your pre-paid orders by mail* The forms are available in packets of 10. Send your check or money order made out to the EMS Bureau to 1301 Siler Road Building F Santa Fe NM 87505 ATTENTION DNR Program For more information Contact DNR Program EMS Bureau Santa Fe NM 87507 PHONE 505-476-8200 FAX 505-471-2121 Quantity per Set Price Totals 1 10 Forms 5 50 Forms 20. The form has 3 parts. One for your patient one for your patient s medical records and one for your patient to order an optional MedicAlert Medallion You may download FREE DNR Forms from nmems. org For individual EMS-DNR forms or questions about the implementation of the EMSDo Not Resuscitate DNR program contact the EMS Bureau at 505-476-8200 ORDER FORM To order your forms send in your pre-paid orders by mail* The forms are available in packets of 10. org For individual EMS-DNR forms or questions about the implementation of the EMSDo Not Resuscitate DNR program contact the EMS Bureau at 505-476-8200 ORDER FORM To order your forms send in your pre-paid orders by mail* The forms are available in packets of 10. Send your check or money order made out to the EMS Bureau to 1301 Siler Road Building F Santa Fe NM 87505 ATTENTION DNR Program For more information Contact DNR Program EMS Bureau Santa Fe NM 87507 PHONE 505-476-8200 FAX 505-471-2121 Quantity per Set Price Totals 1 10 Forms 5 50 Forms 20. The form has 3 parts. One for your patient one for your patient s medical records and one for your patient to order an optional MedicAlert Medallion You may download FREE DNR Forms from nmems. org For individual EMS-DNR forms or questions about the implementation of the EMSDo Not Resuscitate DNR program contact the EMS Bureau at 505-476-8200 ORDER FORM To order your forms send in your pre-paid orders by mail* The forms are available in packets of 10. Send your check or money order made out to the EMS Bureau to 1301 Siler Road Building F Santa Fe NM 87505 ATTENTION DNR Program For more information Contact DNR Program EMS Bureau Santa Fe NM 87507 PHONE 505-476-8200 FAX 505-471-2121 Quantity per Set Price Totals 1 10 Forms 5 50 Forms 20.

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