How to Fill Out a Do-Not-Resuscitate Form

|

Aug 19, 2024

Trustworthy is an intelligent digital vault that protects and optimizes your family's information so that you can save time, money, and enjoy peace of mind. Learn more from our webinar recording.

how to fill out a do not resuscitate form

How to Fill Out a Do-Not-Resuscitate Form

|

Aug 19, 2024

Trustworthy is an intelligent digital vault that protects and optimizes your family's information so that you can save time, money, and enjoy peace of mind. Learn more from our webinar recording.

How to Fill Out a Do-Not-Resuscitate Form

|

Aug 19, 2024

Trustworthy is an intelligent digital vault that protects and optimizes your family's information so that you can save time, money, and enjoy peace of mind. Learn more from our webinar recording.

how to fill out a do not resuscitate form

How to Fill Out a Do-Not-Resuscitate Form

|

Aug 19, 2024

Trustworthy is an intelligent digital vault that protects and optimizes your family's information so that you can save time, money, and enjoy peace of mind. Learn more from our webinar recording.

how to fill out a do not resuscitate form

The intelligent digital vault for families

Trustworthy protects and optimizes important family information so you can save time, money, and enjoy peace of mind

The intelligent digital vault for families

Trustworthy protects and optimizes important family information so you can save time, money, and enjoy peace of mind

Choosing to create a do-not-resuscitate (DNR) order is a big decision and should not be taken lightly. It likely came with many hours of thinking and consultations with your healthcare provider. So, it’s important to fill out the DNR form correctly. 

An incorrectly filled-out DNR form can result in an invalid DNR order, and when the time comes, your healthcare provider may end up going against your wishes. We’ll explain how to avoid this by discussing where to find the form, how to fill it out, and give other important information.

Key Takeaways 

  • A DNR form contains your end-of-life wishes and, legally, it cannot be ignored by healthcare providers.

  • A DNR form has your personal details, CPR preferences, and signatures from you and your healthcare provider.

  • Not filling out the whole form, using the wrong form, and not having all required signatures can result in an invalid DNR. 

Understanding a Do-Not-Resuscitate Form 

understanding a do not resuscitate form

The DNR form is generally not the most complicated medical form you’ll ever have to fill out. However, you must fill it out correctly and according to your state’s requirements. 

A DNR is an end-of-life medical directive that instructs all healthcare providers and emergency staff who are taking care of you to withhold life-sustaining treatment, especially if you are not in the position to communicate. 

This order specifically refers to cardiopulmonary resuscitation (CPR) and other other resuscitation methods like:

  • Cardiac compression (or chest compressions).


  • Artificial ventilation (mouth-to-mouth breathing).


  • Defibrillation (electrical shock).


  • Intubation (involving a respiratory tube).

On your DNR form, the same information is generally required across all states, with a few differences in specific requirements. You may also find that depending on your location, a DNR may go by other names such as:

DNAR (do not attempt resuscitation).

POLST (physician orders for life-sustaining treatment).

MOLST (medical orders for life-sustaining treatment).

AND (allow natural death).

Aside from these two things, a DNR typically includes your specified preferences regarding CPR and additional instructions. It also includes your full name and the state that you live in. There will also be a number of signatures on it, including yours and others, depending on the state’s requirements.   

When filling out a DNR you should note that this does not apply to other types of medical treatments like pain relievers, antibiotics, and other relevant medications for your condition. 

Where to Get a Do-Not-Resuscitate Form

Getting a copy of a DNR form is easy since they’re available for free through multiple platforms. You can easily and conveniently download DNR templates online through various websites like egaltemplates.net and eforms.com

Official government websites also provide PDF copies of DNR forms and other useful forms and information that you may need as well. 

You can also obtain a DNR from your healthcare providers by requesting a consultation with them. During this consultation, you can explain your desire for a DNR and your healthcare provider will guide you through the process of obtaining one, filling out the form, and explaining the risks and realities of a DNR. 

DNR forms can also be obtained from hospices. In fact, most hospice providers will provide DNR forms to their patients who are receiving end-of-life care as part of their services and provide expert assistance with filling out the form. 

However you choose to obtain your DNR order form, you must store it in a safe place like Trustworthy

Trustworthy's award-winning Family Operating System® that can be used to store all your end-of-life documents like your DNR. Trustworthy keeps your documents safe thanks to the cutting-edge security used, such as 256-bit AES encryption and two-factor authentication, and it is compliant with HIPAA.  

Steps to Fill Out a Do-Not-Resuscitate Form

steps to fill out a do not resuscitate form

Here are the steps for filling out a DNR form.

  1. Consult with your healthcare provider: Once you make the decision to order a DNR, you will need to consult with your healthcare provider to discuss the realities of obtaining your DNR. 

  2. Obtain the DNR form: You can obtain the DNR form through the different methods already mentioned, but it’s a good idea to get it from your healthcare provider during the consultation. 

  3. Fill out your personal information: To start, you must complete your personal information on the form. This will include your full name, address, and your date of birth. You need to ensure this is correct, otherwise, your DNR won’t be valid.

  4. Indicate your CPR wishes: On the form, you will have the opportunity to indicate your wishes regarding resuscitation. Some forms provide options for the refusal of CPR, mechanical ventilation, defibrillation, and others. If you have any questions, ask your healthcare provider for clarity and assistance.

  5. Inform your healthcare proxy: If you appointed a medical power of attorney, you will need to discuss your DNR wishes with them as well.

  6. Sign the DNR form: This is the important part. Different states have their own requirements you must be aware of to ensure your DNR is valid. For example, you may only need your and your healthcare provider’s signatures, or you may need additional signatures from witnesses. 

  7. Share copies: Once you complete the DNR form, your healthcare provider will distribute this information to other medical providers. You should also share this information with your family so they are aware of your end-of-life wishes. 

Share your DNR with Trustworthy’s collaboration feature, which allows you to decide who has access to your important documents. 

Common Mistakes When Filling Out a DNR Form

Avoid complications and misunderstandings with your end-of-life wishes by avoiding these common mistakes.

  • Using the wrong form: Ensure you use the correct form for the state you live in. 


  • Incomplete forms: Even just forgetting to complete a small section or piece of information can make your DNR invalid. Ensure you have filled out everything on the form.

  • No witnesses or lack of signatures: Every state has its own signature preferences, and failure to obtain the correct ones can mean your DNR is invalid.

  • Not distributing your forms: Filling out your DNR correctly is of no use to you if you have not informed your healthcare provider or loved ones of your decision.

  • Not reviewing your DNR: If your medical condition has changed and you no longer wish for a DNR but don’t revoke the order, this can have serious and fatal consequences. 

Discussing DNR Wishes With Family and Healthcare Providers

discussing dnr wishes with family and healthcare providers

Once you make your decision and fill out the DNR form, your next course of action is to discuss your end-of-life wishes with your family and healthcare providers.

During your consultation, you discuss your inventions with your healthcare provider, and generally, they pass this information on to your other healthcare providers and add it to your medical record. 

However, discussing your DNR wishes with your family is a much harder conversation, but it’s crucial. When talking about your DNR wishes with family, it’s all about picking the right time. Talk when everyone is calm and focused. Avoid just dropping the news during a chaotic or rushed moment. 

Be clear and direct about your intentions. Remember, this may be hard for your loved ones to understand, and they may have questions or concerns. Take the time to answer these questions patiently and avoid getting defensive. They don’t have to agree with your decision, but they will understand and must accept it. 

Having a documented copy of your conversation with healthcare providers and your loved ones in writing is a great idea to ensure everyone is on the same page. You can store this document with Trustworthy and create a trusted network of people who have access to information at all times in case of an emergency.  

Storing and Accessing Your DNR Form

It’s important to keep your DNR order somewhere that is safe and easily accessible. This ensures all personnel caring for you during a medical emergency where you are incapacitated are aware of your end-of-life wishes. 

Heidi Garvis, an aging life care consultant and certified senior advisor in Virginia, believes that one of the best places to keep your DNR form is a note on the fridge door. She explains:

“What people don’t understand is that in a crisis situation, no one is going to look in a safe or a locked drawer. Plain sight is what works.”

Avoid storing your DNR somewhere that is not common, like an in-home safe. During an emergency, first responders may not know where it is or how to access it if you are incapacitated. 

Some people choose to wear medical jewelry like bracelets and necklaces that inform healthcare providers and first responders that they have a DNR.  

Storing physical copies puts the risk of misplacing or losing them at a higher chance. Take advantage of a secure digital storage platform like Trustworthy

Trustworthy is a digital safe deposit box that can help keep important documents safe without the hassle of filing physical documents. With Trustworthy, you can ensure that your DNR is always accessible to those who need it, regardless of their location.

Frequently Asked Questions

Who should have a DNR form?

Anyone who wishes to create a DNR will need to fill out a form. Copies of this form will need to be shared with their healthcare provider, medical power of attorney as well as loved ones. 

Do I need a lawyer to fill out a DNR form?

No, but you can require the assistance of a lawyer to explain the risks and benefits of a DNR. 

Can I change or cancel my DNR once it’s done?

Yes, you can legally revoke or change your DNR at any time as long as you inform your healthcare provider of the changes immediately. 

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