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Signature of Patient or Health Care Proxy or Legal Guardian Date ATTENDING PHYSICIAN'S ORDER I, the undersigned, state that I am the physician for the patient named above. I hereby direct any and all qualified Emergency Medical Services personnel, commencing on the effective date noted below, to withhold cardiopulmonary resuscitation (cardiac compression, endotracheal intubation and other advanced airway management, artificial ventilation, defibrillation, administration of.

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Medical professionals who give CPR to people with a DNR order can potentially get into trouble—if they are aware of the DNR. The legal ramifications of giving CPR to someone with a DNR are complex. In some states, DNR orders are only valid within a hospital setting; outside of that, they don't apply.

These forms are available only to physicians' offices or other licensed hospital or healthcare facilities. To purchase DNR and MOST forms, use the DNR and MOST order form: DNR & MOST Order Form (PDF, 54 KB)

When submitted to a hospital, an individual can request this form through their physician. Alternatively, one could ask their physician ahead of time for a DNR form, which would alert emergency responders/personnel, paramedics, etc. of the individual's wishes.

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.

Generally, a DNR order should not be entered into the patient's medical record without concurrence of the parents. However, a DNR order may be entered by the patient's physician without parental permission if CPR is determined to be physiologically futile or non-therapeutic, in ance with Paragraphs E and F below.

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.

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).

A DNR is a request not to have CPR if your heart stops or if you stop breathing. You can use an advance directive form or tell your doctor that you don't want to be resuscitated. Your doctor will put the DNR order in your medical chart.

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© Copyright 1997-2025
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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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