Alaska do not resuscitate

Document Name

Emergency Medical Services Prehospital Do Not Resuscitate Order

Where do you get the form

You can also request a copy from the State Emergency Medical Services Department.

Who signs the form

The form is signed by the physician, the patient, and the health care agent named in the health care power of attorney form.

Patient Identification

The form is a three-part form. Give a copy of the form to EMS personnel.

How do you obtain a DNR bracelet

If you decide to wear a DNR bracelet, ask your physician to order a Comfort One DNR bracelet for you. There is a nominal fee to obtain a DNR bracelet.

Revoking a DNR

If you change your mind, destroy the enrollment forms and the wallet card. Notify your physician in writing that you have changed your mind.

State links

http://www.chems.alaska.gov/ems/Comfort_One.htm

Other links

http://www.vialoflife.com/

Special Notes

Order a Vial of Life decal for your front door. The decal informs Emergency Medical Services team a DNR has been prepared and can be found in your refrigerator.

Tagged as: alaska comfort one, Alaska DNR bracelet, Alaska do not resuscitate, do not resuscitate (DNR)

{ 0 comments }