Hawaii Do Not Resuscitate (DNR) Form

Hawaii Do Not Resuscitate (DNR) Form

A Hawaii do not resuscitate form allows a patient to advise health care professionals not to provide certain types of life-sustaining treatments when they are close to death. This is accomplished through a POLST form in Hawaii, which not only lets the patient deny CPR intervention but enables them to select specific medical treatments and artificial nutrition options.

Last updated June 5th, 2025

A Hawaii do not resuscitate form allows a patient to advise health care professionals not to provide certain types of life-sustaining treatments when they are close to death. This is accomplished through a POLST form in Hawaii, which not only lets the patient deny CPR intervention but enables them to select specific medical treatments and artificial nutrition options.

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Signing Requirements

The Hawaii POLST form must be executed by the patient (or their representative) and the patient’s health care provider.[1]

Formatting

A POLST form is typically printed on bright lime green paper so that EMS staff can easily recognize what medical interventions the patient has requested. However, documents printed on plain white paper are equally legal and valid.

Do Not Resuscitate (Preview)

Sources

  1. § 327K-2(a)