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How to fill out the Do Not Resuscitate Illinois online
The Illinois Do Not Resuscitate (DNR) form is a vital document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. This guide provides step-by-step instructions on how to fill out the DNR form accurately and effectively online.
Follow the steps to complete the Do Not Resuscitate form online
- Click ‘Get Form’ button to access the Do Not Resuscitate form and open it for editing.
- In the first section, print your full name and birth date clearly. This identifies the person for whom the DNR order applies.
- Indicate your wishes for full cardiopulmonary arrest by selecting 'Do Not Attempt Cardiopulmonary Resuscitation (CPR).' This confirms that you do not wish to be revived if both your breathing and heartbeat stop.
- In the pre-arrest emergency section, you must choose between 'Do Attempt Cardiopulmonary Resuscitation (CPR)' or 'Do Not Attempt Cardiopulmonary Resuscitation (CPR).' Select the option that best reflects your preferences. Additional instructions can be provided in the space provided.
- Sign and date the authorization section to give consent for this directive to be valid. If applicable, include the printed name and signature of a legal guardian, agent under health care power of attorney, or healthcare surrogate decision maker.
- If needed, have a witness sign the consent section, confirming they are at least 18 years old and acknowledge your decision in their presence.
- The attending physician must then sign the order. This is crucial as it validates the DNR order.
- Finally, make sure to save your changes. You can then download, print, or share the form with the appropriate healthcare provider, ensuring it accompanies any transfer or discharge.
Complete your Do Not Resuscitate Illinois form online today to ensure your health care preferences are respected.
A DNR order may be invalidated if the immediate cause of a respiratory or cardiac arrest is related to trauma or mechanical airway obstruction.
Fill Do Not Resuscitate Illinois
(POLST) is always voluntary. People have the right to refuse medical treatment and may choose not to receive CPR. Ill. Admin. Code tit. 77, § 515.380 - Do Not Resuscitate (DNR) and Practitioner Orders for Life-Sustaining Treatment (POLST) Policy. An Illinois Do Not Resuscitate order form (DNR) ensures that medical providers do not attempt CPR on an individual should the need arise. Do-Not-Resuscitate Orders and Department of Public Health Uniform POLST form.
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