- Document Name
- Emergency Medical Services Prehospital Do Not Resuscitate Order
- Where do you get the form
- You can get the form from your physician or other medical personnel.
- Who signs the form
- The form is signed by the physician and the patient.
- 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. The cost is $20.
- Revoking a DNR
- If you change your mind, destroy the enrollment forms, the wallet card and, if appropriate, the DNR bracelet. Also, notify your physician in writing that you have changed your mind. If you are unable to communicate yourself, a person with a durable power of attorney can revoke the DNR status.
- State links
- http://dhss.alaska.gov/dph/Emergency/Pages/ems/programs/comfort_one.aspx
- 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.