Indiana Do Not Resuscitate Form With 2 Points

State:
Indiana
Control #:
IN-P022B
Format:
Word; 
Rich Text
Instant download

Description

The Indiana do not resuscitate form is a legal document that allows individuals to revoke a previously established out-of-hospital do not resuscitate declaration and physician's order. Key features of the form include the ability for the declarant to withdraw consent for treatment at any time, as specified under IC 16-36-1.5-10, and a space for the declarant's signature, printed name, and address. Filling and editing instructions emphasize the importance of clearly stating the intent to revoke the declaration. Users are required to complete the date of revocation and provide their personal information to ensure proper identification. This form is particularly relevant for attorneys, partners, owners, associates, paralegals, and legal assistants as it helps facilitate discussions about advance care planning with clients. It allows legal professionals to assist individuals in understanding their rights regarding life-sustaining treatments and ensures that such preferences are documented legally.

How to fill out Indiana Revocation Of Out Of Hospital - Do Not Resuscitate Declaration - DNR?

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FAQ

Hear this out loud PauseThe 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.

Hear this out loud PauseI, _________________________________________, 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.

The mission of the Indiana Department of Natural Resources is to protect, enhance, preserve, and wisely use natural, cultural, and recreational resources for the benefit of Indiana's citizens through professional leadership, management, and education.

Hear this out loud PauseCreating 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.

Hear this out loud PauseA DNR order does not mean "do not treat." Rather, it means only that CPR will not be attempted. Other treatments (for example, antibiotic therapy, transfusions, dialysis, or use of a ventilator) that may prolong life can still be provided.

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Indiana Do Not Resuscitate Form With 2 Points