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The patient's physician must approve of a DNR, confirming the patient's condition by signing the DNR form. Aside from the patient's and physician's signatures, two (2) witnesses are required to make a DNR order valid. Required to Sign ? Patient, physician and two (2) witnesses.
National Resources on Advance Care Planning and COVID-19. NEW! Indiana Out-of-Hospital DNR Order Form (English) An Out-of-Hospital Do Not Resuscitate (DNR) order directs emergency responders to withhold resuscitation in the event that a person's heart and breathing stop.
Creating a DNR is simple and affordable at 12 Law. The only person that you need it signed with is your doctor and the presence of an adult witnesses or a lawyer who will witness for you as you sign the document.
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.