Document Name:

Illinois Department of Public Health (IDPH) Uniform Do-Not_Resuscitate (DNR) Advance Directive

Where do you get the form

To obtain a copy of the IDPH Uniform DNR form, you may request one from your health-care professional or facility. Copies also are available on the Illinois Department of Public Health’s Web site located at http://www.idph.state.il.us/public/books/advin.htm or by calling 217-785-2080

Who signs the form

The form is signed by the physician, the patient, and one witness.

Who can request a DNR

     An adult or an emancipated minor who does not wish to have CPR attempted when his or her heart and/or breathing stops may have a DNR order.

Patient Identification

There is no requirement for a patient to wear a DNR identification bracelet. EMS will honor a DNR form signed by a physician, patient and one witness.

How do you obtain a DNR bracelet

The IDPH does not specify any specific company from which to purchase the bracelet.  You should ask your physician for a recommendation when meeting to discuss the DNR form.

Revoking a DNR

The DNR order can be revoked in a variety of ways, such as by writing “VOID” in large letters across the front of the form. If you revoke a DNR order, you also should tell your family members, as well as each health-care professional and provider that has received a copy of the order. You may then choose not to have a DNR order, or you may choose to complete a new DNR order reflecting any changes you wish.

Photocopy

Photocopies of a completed IDPH Uniform DNR are valid.

State info link

http://www.idph.state.il.us/public/books/advdir4.htm

State statute link:

http://www.ilga.gov/legislation/ilcs/documents/075500400K65.htm

Other links

DNR Bracelet links

Illinois does not recommend a specific vendor.  However, here’s one you might try:

Medic Alert Foundation International http://tinyurl.com/dk3yun

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.  http://www.vialoflife.com/