We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • New York State Department Of Health Nonhospital Order Not To Resuscitate Form. Form Doh-3474

Get New York State Department Of Health Nonhospital Order Not To Resuscitate Form. Form Doh-3474

State of New York Department of Health Nonhospital Order Not to Resuscitate (DNR Order) Person's Name O D Date of Birth / / Do not resuscitate the person named above. O N Physician's Signature T Print.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the New York State Department Of Health Nonhospital Order Not To Resuscitate Form, Form DOH-3474 online

The New York State Department Of Health Nonhospital Order Not To Resuscitate Form (Form DOH-3474) is an important document for individuals wishing to express their preferences regarding resuscitation in a nonhospital setting. This guide aims to provide clear, step-by-step instructions for completing the form online, ensuring that users can easily navigate the process.

Follow the steps to complete the form accurately and efficiently.

  1. To obtain the form, press the ‘Get Form’ button to access it and open it in the editor.
  2. In the first field, enter the person's name as it appears on their legal documents.
  3. Next, fill in the date of birth in the format of month, day, and year (MM/DD/YYYY).
  4. Indicate the decision not to resuscitate the person by selecting the appropriate option.
  5. The physician must provide their signature in the designated area to validate the order.
  6. Print the physician's name clearly in the next field, ensuring accuracy.
  7. The physician's license number should be entered in the corresponding field.
  8. Lastly, the physician should sign and date the form again using the MM/DD/YYYY format.
  9. After completing the form, users can save changes, download, print, or share the completed document as needed.

Start completing your documents online today to ensure your preferences are known and documented.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

DNR Order - New York State Department of Health
Do not resuscitate the person named above. ... and under the law this order should be...
Learn more
Nonhospital Order Not to Resuscitate (DNR Order)...
New York Elder Law. Book Publication Date: Nov 2020. Description: Nonhospital Order Not to...
Learn more

Related links form

Evolution Webquest Answers Copyright 1982 Dandy Lion Publications Answers Colorado Lead Based Paint Discosure Form LP46-05-04.pdf Master Folio Form 061217.cdr - Birla Sun Life Mutual Fund

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

For example, someone with terminal cancer might write that they do not want to be put on a respirator (breathing machine) if they stop breathing. This action can increase their control over their death and their peace of mind, and eventually reduce their suffering.

I, _________________________________________, request limited emergency care as herein described. I understand DNR means that if my heart stops beating or if I stop breathing, no medical procedure to restart breathing or heart functioning will be instituted.

Did you know that there are two different types of DNR orders that can be chosen? The first is the DNR Comfort Care (DNRCC) and the other is the DNR Comfort Care- Arrest (DNRCC-Arrest).

If you decide you want a DNR order, tell your doctor and health care team what you want. Your doctor must follow your wishes, or: Your doctor may transfer your care to a doctor who will carry out your wishes.

Regardless of the format or the venue, DNR orders almost always follow the same general rules to be valid: DNR orders must be written by medical professionals rather than verbalized. ... Written DNR orders must include the patient's name. ... DNR orders must be dated. ... The DNR order must be signed by the healthcare provider.

Discuss a DNR order. Use language that the patient will understand; give information in small pieces. Don't introduce CPR in mechanistic terms (e.g. “starting the heart” or “putting on a breathing machine”). Never say Do you want us to do everything?

How can I write an advance directive? Use a form provided by your doctor. Write your wishes down by yourself. Call your health department or state department on aging to get a form. Call a lawyer. Use a computer software package for legal documents.

The New York DNR (for Do-Not-Resuscitate) Form is a medical, legal document that a person needs to ban a medical procedure known as resuscitation. This ban will instruct paramedics (or other medical personnel) not to take action to bring a person to life.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get New York State Department Of Health Nonhospital Order Not To Resuscitate Form. Form DOH-3474
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232