DNR Medical Form

The DNR medical form refers to a medical order that is filled in by a doctor. The DNR, or do not resuscitate, contains an instruction for the health care providers so they will not perform CPR or cardiopulmonary resuscitation when a patient’s breathing stops or when his or her heart stops beating. You can find the printable do not resuscitate form as a reference of how the form looks like, although this one can only be completed by a doctor.

The DNR order is set up or created before any emergency occurs. Broadly speaking, this contains information whether you’d like to have CPR or not in an emergency, which can be seen in the sample of do not resuscitate form PDF you can download for free from the internet. The form is specific about CPR only, so it does not contain any instructions for other types of treatment, such as nutrition, other medicines, or pain medicine.

When possible, the DNR medical form will be written by the doctor only after he or she has talked about it with the patient. The doctor is also allowed to write it after talking with the patient’s family or the proxy.

 

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A DNR order may also be a part of the hospice care plan, which focus is not to prolong life. Rather, it focuses on treating symptoms of shortness of breath or pain, in addition to maintain comfort. As long as you have a DNR order, you can still have the right to request CPR.

When you finally decide that you’d like to have a DNR order, you need to tell the health care team and doctor what you want. Your doctor is obliged to follow your wishes. On the other hand, your doctor may also:

  • Transfer your care to a different doctor who will do as you wish, or
  • Agree to settle any possible disputes within 72 hours if you’re a patient in a nursing home or hospital so that he’d follow your wishes.

To fill out the DNR order form, your doctor can do so on your medical chart, which is the case if you’re in the hospital. Alternatively, your doctor can also tell you how to get the DNR documents, such as a bracelet or wallet card, to have in non-hospital settings, such as at home. For the standard form, you can access and download it from the state’s Department of Health.

Do not forget to include your wishes in a health care power of attorney or living will and inform your family and health care agent regarding your decision. The same goes when you change your mind—talk with your health care team or doctor immediately, in addition to your caregivers and family.

Aside from the details covered in the DNR medical form, your family member or friend may also agree to a DNR order for you when you haven’t named someone to rep you. However, remember that this only applies when you’re not able to make your own decisions.

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