- Document Name
- Do Not Resuscitate Order
- Where do you get the form
- Physicians should have copies of the form. You can download a copy of the form here: http://tinyurl.com/ktsc6n
- Who signs the form
- Michigan has two DNR forms. One form enables a physician to sign the DNR. The other DNR form does not require a physician signature to be an authentic document.
- Patient Identification
- EMS will act based uon the information contained in the DNR.
- How do you obtain a DNR bracelet
- Once you have your DNR form completed, you can call one of the numbers listed below and request a DNR bracelet.
- Revoking a DNR
- You can revoke a DNR by tearing up the DNR form and returning any DNR identification bracelets.
- Photocopy
- A photocopy is considered an authentic document
- State info link
- http://tinyurl.com/ktsc6n
- Other link
- http://www.vialoflife.com
- DNR Bracelet links
- Once you complete the DNR form, you can order a DNR bracelet. There is no requirement for information from the form to be available on the bracelet.
- Special Notes
- Once you complete the DNR form, you can order a DNR bracelet. There is no requirement for information from the form to be available on the bracelet.
Tagged as:
DNR form,
do not resuscitate (DNR),
do not resusitate,
Michigan Do Not Resuscitate Order
- Document Name
- Comfort Care/Do Not Resuscitate Order Verification
OR
Custom Care/Do Not Resuscitate Order Verification With Bracelet
- Where do you get the form
- A physician must complete a DNR form on your behalf. If you want to order a bracelet, the physician will complete the DNR Order Verification With Bracelet form.
If your physician does not have a form, click here:
http://tinyurl.com/c627vx.
- Who signs the form
- The form is signed by the physician, the patient, and two witnesses. The DNR Verification with Bracelet form must be printed on 8 1/2 inch by 14 inch legal size paper.
- Patient Identification
- The Comfort Care/DNR verification is the only document that EMS personnel can use to verify a DNR order is valid.
- How do you obtain a DNR bracelet
- Your physician must order a DNR bracelet for you.
- Revoking a DNR
- An EMS/DNR Order may be revoked at any time by the patient’s request for resuscitation made directly to responding emergency medical services personnel OR by the physical cancellation or destruction of all EMS/DNR Order forms, bracelets, and necklaces with the consent of the patient or the authorized decision maker signing the EMS/DNR Order. Destruction of an EMS/DNR Order, bracelet, or necklaces without consent carries penalties under the Health Care Decision Act.
- Photocopy
- Photocopies of the form or the bracelet inserts are not considered authentic DNR documents. If you need a document at more than one location, create multiple original documents.
- State info link
- http://tinyurl.com/c627vx
- Other links
- http://www.vialoflife.com/
- DNR Bracelet links
- Your physician must order a DNR braclet on your behalf.
- 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. The Customer Care/Do Not Resuscitate Order Verification assumes the patient has completed a separate DNR form. The DNR Order Verification form provides a way to document the existence of a DNR in out of hospital situations.
Tagged as:
DNR bracelet,
DNR form,
DNR Order,
do not resuscitate (DNR),
do not resusicate,
Massachusetts DNR
- Document Name
- Do Not Resuscitate Order
- Where do you get the form
- Ask your physician to create a DNR on your behalf. The physician will prepare and sign the form.
- Who signs the form
- Ask your physician to create a DNR on your behalf. The physician will prepare and sign the form.
- Patient Identification
- There is no requirement for a patient to wear a DNR identification bracelet.
- How do you obtain a DNR bracelet
- If you want to wear a DNR bracelet, you can order one from one of the links listed below.
- Revoking a DNR
- You, or your designated health care agent, can give different instructions at any time, either orally, or by notifying your physician in writing.
- Photocopy
- You can make a photocopy of the original DNRO form, but it must be copied on canary yellow paper.
- State info link
- http://tinyurl.com/ddgby4
- Other link
- http://www.vialoflife.com/
- DNR Bracelet links
- 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. The original DNRO order MUST be printed on YELLOW stock, 8 ½ 14, legal size paper. The laminated patient identification record has the same legal authority as the original DNRO order.
Tagged as:
DNR form,
DNR rder,
do not resuscitate (DNR),
do not resusitate,
georgia do not resuscitate order
- Document Name:
- “Do Not Resuscitate Comfort Care Order ” OR ” Do Not Resuscitate Comfort Care Order-Arrest Order”
- Where do you get the form
- A physician, a certified nurse practitioner or a clinical nurse specialist can complete the form. If you need to provide a form to your physician, click here
- Who signs the form
- The physician and the patient can consent to a DNR order.
- Patient Identification
- A wallet card, an EMR hospital bracelet or the completed form can be used by EMS personnel.
- How do you obtain a DNR bracelet
- Once the DNR form is signed, you can obtain a bracelet.
- Revoking a DNR
- You may revoke the DNR at any time, either orally or in writing. You may also revoke the DNR by destroying the DNR form, wallet card or DNR bracelet.
- Photocopy
- A photocopy is recognized as an authentic DNR form.
- State info link:
- http://codes.ohio.gov/orc/2133.02
- Other links:
- http://www.vialoflife.com/
- DNR Bracelet links
- DNR bracelets may be obtained from most companies that sell medical identification bracelets, provided they have a copy of your Ohio DNR form on file. Some bracelet sources include:
- 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.
Ohio has two types of DNR forms. In addition, your Living Will may include some DNR language. Discuss these options with your physician or attorney and select the one appropriate for your intentions.
Tagged as:
DNR form,
DNR Order,
do not resuscitate (DNR),
do not resusitate,
Ohio do not resuscitate order
- Document Name
- “Nonhospial Order Not to Resuscitate”
- Where do you get the form
- Only a licensed physician can complete the form. and he or she. should have a copy of the DNR Order. If you need to provide a for to your physician, click here: http://tinyurl.com/djekqu
- Who signs the form
- The physician and the patient can consent to a DNR order orally or in writing, if two adult witnesses are present. When consent is given orally, one of he witnesses must be a physician affiliate with th hospital.
- Patient Identification
- New York EMS will honor the DNR Order form or a DNR bracelet issued by Medic Alert.
- How do you obtain a DNR bracelet
- Once the DNR form is signed, you can obtain a bracelet Medic Alert.
- Revoking a DNR
- You, or anyone who consents to a DNR order on your behalf, can remove the order by telling doctors, nurses or others about the decision. This need not be done in writing. Once informed of your wishes, your physician must record the DNR revocation in your chart, cancel the DNR order and make diligent efforts to retrieve all copies of your DNR form, as well as your DNR bracelet.
- Photocopy
- A photocopy is recognized as an authentic DNR form.
- State info link
- http://tinyurl.com/cksdvz
http://tinyurl.com/dna9dm
- Other link
- http://www.vialoflife.com/
- DNR Bracelet links
- DNR bracelets may be obtained from most companies that sell medical identification bracelets, provided they have a copy of your New York DNR form (DOH-3474) on file. Some bracelet sources include:
- Appomattox Drug Store, PO Box 489, Appomattox, VA 24522. Telephone 1-800-330-7225 ex. 102, or order on-line at http://tinyurl.com/cf5jdq
- Medic Alert Foundation International, Attn DNR, 2323 Colorado Avenue, Turlock, CA 95382 Phone: 1-888-633-4298, 3, 1 or ask for DNR. http://tinyurl.com/dlkluh
Medical Identification Jewelry (on-line orders only) at http://tinyurl.com/dk3yun or http://tinyurl.com/cs983u
- 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:
DNR form,
DNR Order,
do not resuscitate (DNR),
do not resusitate,
New York do not resuscitate form
