This is a form initiated by a patient requesting that he/she not be resuscitated should he/she stop breathing or should his/her heart stop beating. This form is also to be signed by a physician attesting to patient's wishes and to be placed in the patient's file.
Arizona Do Not Resuscitate Request - DNR
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Multi-State
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US-PRM-12
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Word;
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How to fill out Do Not Resuscitate Request - DNR?
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Step 6 A notary public or adult witness must be present when the DNR form is signed. The witness cannot be under the age of eighteen (18), related to the patient, entitled to a portion of the patient's estate, appointed as the patient's representative or involved in providing health care to the patient.
Unlike other states, Arizona does not require the signature of the person's attending physician on a DNR form. Any licensed healthcare provider can sign the form if they acknowledge that they have advised the person that the withholding of cardiopulmonary resuscitation efforts could result in death.
The usual circumstances in which it is appropriate not to resuscitate are: when it will not restart the heart or breathing. when there is no benefit to the patient. when the benefits are outweighed by the burdens.
The form must be signed by you (the patient), a licensed healthcare provider and a witness. 2 ways to request a DNR form: Click here to download the DNR form now (print on orange paper) Call 602- 542-2123 or 800-352-8431 and leave a message.
Summary. The main point is this: as a bystander, i.e. a non-medical professional, you cannot get into any legal trouble for giving CPR to a person with a DNR, and should always give CPR as soon as possible to all victims of sudden cardiac arrest.
Do not resuscitate order 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. Doctors and hospitals in all states accept DNR orders.
Do not resuscitate orderA 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. Doctors and hospitals in all states accept DNR orders.
Arizona law A.R.S. §36-3251 authorizes the Prehospital Medical Care Directive, which is commonly referred to as the Do Not Resuscitate or DNR form. As the name indicates, the DNR instructs certain medical personnel to forgo resuscitation if the patient stops breathing or if the patient's heart stops beating.
notresuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on country, indicating that a person should not receive cardiopulmonary resuscitation (CPR) if that