Indiana Do Not Resuscitate (DNR) Form

Indiana Do Not Resuscitate (DNR) Form

An Indiana do not resuscitate form can be used by patients with end-stage illnesses to declare that they do not want CPR if their heart or breathing stops. With a DNR in place, other comfort measures and pain interventions may be administered, but resuscitation procedures will be avoided so the patient can die a natural death.

Last updated July 8th, 2025

An Indiana do not resuscitate form can be used by patients with end-stage illnesses to declare that they do not want CPR if their heart or breathing stops. With a DNR in place, other comfort measures and pain interventions may be administered, but resuscitation procedures will be avoided so the patient can die a natural death.

  1. Home »
  2. Do Not Resuscitate (DNR) Forms »
  3. Indiana

Signing Requirements

A DNR form must be executed by the patient or their representative, two witnesses, and the attending physician, APRN, or PA.[1]

Out-of-Hospital

This DNR form is an out-of-hospital order, so patients can be certain EMS and other health care providers will not perform CPR outside of a hospital setting.

Do Not Resuscitate (Preview)