- Document Name
- Do Not Resuscitate Order
- Where do you get the form
- Ask your physician to create a DNR on your behalf. If your physician does not have a form, there is a sample as part of the Georgia statute. Go to: http://www.lexisnexis.com/hottopics/gacode/Default.asp and then look for Title 31. Health Chapter 39. O.C.G.A. 31-39-4.
- Who signs the form
- The physician will sign the form.
Who can request a DNR
Any patient who has a medical condition which can be expected to result in imminent death or for whom CPR would be medically futile because it might only restore cardiac and respiratory function for a brief period of time. A legal representative can also request a DNR for a patient who is in a vegetative or other unconscious state.
- Patient Identification
- There is no requirement for a patient to wear a DNR identification bracelet but it is acceptalbe if the patient chooses to do so. However, there are specific guidelines. The bracelet must be similar to identification bracelets worn in hospitals and must provide the following information in boldface type: DO NOT RESUSCITATE ORDER. Patient’s name: _____________; authorized person’s name and phone number, if applicable; patient’s physician’s printed name and phone number; date of order not to resuscitate.
- How do you obtain a DNR bracelet
- For assistance with finding a vendor for bracelets or necklaces, contact the Office of Regulatory Services at (404) 657-4076.
- 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.
- You can make a photocopy of the original DNR form.
- State info link
- Other link
- 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.