Oregon Do Not Resuscitate (DNR) Form – Sample

Oregon Do Not Resuscitate (DNR) Form – Sample

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Last updated July 4th, 2025

An Oregon do not resuscitate form is used to instruct health care professionals on whether to attempt CPR or apply other life-sustaining measures. Oregon uses the Portable Orders for Life-Sustaining Treatment (POLST) program, which offers additional information regarding interventions when the patient has a pulse and is breathing.

An Oregon do not resuscitate form is used to instruct health care professionals on whether to attempt CPR or apply other life-sustaining measures. Oregon uses the Portable Orders for Life-Sustaining Treatment (POLST) program, which offers additional information regarding interventions when the patient has a pulse and is breathing.

Signing Requirements

An Oregon POLST must be signed by one of the following medical professionals[1]:

  • Physician
  • Naturopathic physician
  • Physician assistant
  • Nurse

Order POLST Forms

In Oregon, only health care professionals can order POLST forms, and may do so from the Oregon POLST website.

Sources

  1. ORS 127.663(7)