Create Document
Adobe PDF
Signing Requirements
A DNR form must be completed by a health care provider and signed by a physician, nurse practitioner, or a physician assistant, as well as the patient or a representative authorized to sign on their behalf.[1]
Hospital vs. Prehospital DNRs
The do not resuscitate form provided is called a Prehospital DNR, meaning emergency services will comply with the order anywhere outside of a hospital (e.g., at home, in a long-term care facility).
If a patient is admitted to a hospital, the medical staff should honor a completed prehospital DNR. However, many healthcare facilities have their own policies and forms, so patients are encouraged to complete the healthcare facility’s DNR form upon admission.
Physician Orders for Life-Sustaining Treatment (POLST) Form – For a more extensive selection of life-sustaining treatments, patients can complete this document with their physician, which will be honored anywhere inside and outside of a healthcare facility.