Printable Do Not Resuscitate Order Form for the State of Florida Open Do Not Resuscitate Order Editor

Printable Do Not Resuscitate Order Form for the State of Florida

A Florida Do Not Resuscitate Order (DNRO) form is a legal document that allows individuals to express their wishes regarding resuscitation efforts in case of a medical emergency. This form helps ensure that medical personnel respect a person's preferences for end-of-life care. If you wish to fill out the form, please click the button below.

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Key takeaways

Filling out and using the Florida Do Not Resuscitate Order (DNRO) form is an important process for individuals who wish to express their healthcare preferences. Here are key takeaways to consider:

  1. Understand the Purpose: The DNRO form indicates that you do not want CPR or other resuscitation efforts if your heart stops or you stop breathing.
  2. Eligibility: This form is typically used by individuals with terminal illnesses or severe medical conditions.
  3. Fill it Out Carefully: Complete the form accurately, including your name, date of birth, and signature.
  4. Witness Requirement: The form must be signed by two witnesses who are not related to you or your healthcare provider.
  5. Keep Copies Accessible: Store the completed form in a place where it can be easily found by healthcare providers and family members.
  6. Review Regularly: Revisit your DNRO periodically to ensure it still reflects your wishes, especially after significant health changes.
  7. Communicate Your Wishes: Discuss your decisions with family and healthcare providers to ensure everyone understands your preferences.

Taking these steps can help ensure that your healthcare choices are respected and followed in critical situations.

Documents used along the form

When considering end-of-life care in Florida, the Do Not Resuscitate (DNR) Order is an important document. However, it is often accompanied by other forms that can help clarify a person's wishes regarding medical treatment. Here are some commonly used documents that may complement a DNR Order.

  • Advance Directive: This document outlines an individual's preferences for medical treatment in situations where they cannot communicate their wishes. It can include instructions about life-sustaining treatments and appoint a healthcare surrogate to make decisions on their behalf.
  • Boat Bill of Sale: This document is essential when transferring ownership of a boat in Florida, and it provides a clear record of the transaction. You can find the necessary Boat Bill of Sale form to facilitate this process.
  • Healthcare Surrogate Designation: This form allows a person to appoint someone they trust to make healthcare decisions for them if they become unable to do so. It is crucial for ensuring that medical choices align with the individual’s values and preferences.
  • Living Will: A living will specifies what types of medical treatment a person does or does not want if they are terminally ill or in a persistent vegetative state. It serves as a guide for healthcare providers and family members regarding the person’s end-of-life care wishes.
  • Physician Orders for Life-Sustaining Treatment (POLST): This medical order is designed for individuals with serious health conditions. It translates a patient's wishes into actionable medical orders that healthcare providers must follow, often addressing more specific treatment preferences than a DNR.
  • Do Not Intubate (DNI) Order: Similar to a DNR, this order specifically states that a patient does not wish to be intubated or placed on a ventilator. It is particularly relevant for individuals who may want to avoid invasive respiratory support.
  • Organ Donation Consent: This form allows individuals to express their wishes regarding organ donation after death. It ensures that their intentions are respected and can be vital in life-saving situations for others.

Understanding these documents can empower individuals to make informed decisions about their healthcare preferences. It is essential to discuss these forms with loved ones and healthcare providers to ensure that everyone is aware of and respects your wishes.

Similar forms

  • Living Will: A living will outlines a person's preferences regarding medical treatment in situations where they cannot communicate their wishes. Like a DNR, it focuses on end-of-life care and can specify the types of treatments a person does or does not want.

  • Healthcare Power of Attorney: This document designates an individual to make medical decisions on behalf of someone else. Similar to a DNR, it comes into play when the individual is unable to express their wishes, ensuring that their healthcare preferences are honored.

  • Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that details a patient's preferences for treatment in emergencies. It is similar to a DNR in that it provides clear instructions to healthcare providers about the patient's wishes regarding resuscitation and other life-sustaining measures.

  • Texas Boat Bill of Sale Form: When transferring boat ownership, be sure to complete the essential Boat Bill of Sale form to protect both parties and ensure a legally sound transaction.
  • Advance Directive: An advance directive is a broader term that encompasses both living wills and healthcare powers of attorney. It allows individuals to communicate their healthcare preferences, including their desires related to resuscitation, similar to a DNR.

  • Do Not Intubate (DNI) Order: A DNI order specifies that a patient should not be intubated if they cannot breathe on their own. This document is similar to a DNR as it outlines specific medical interventions that a patient does not wish to receive in critical situations.

Document Features

Fact Name Description
Definition A Florida Do Not Resuscitate (DNR) Order is a legal document that allows a person to refuse resuscitation efforts in the event of cardiac arrest or respiratory failure.
Governing Law The Florida DNR Order is governed by Section 401.45 of the Florida Statutes.
Eligibility Any adult can complete a DNR order, but it must be signed by a licensed physician to be valid.
Form Requirements The DNR form must be printed on bright yellow paper to ensure it is easily recognizable by emergency medical personnel.
Revocation A DNR order can be revoked at any time by the person who signed it or their legal representative.
Emergency Medical Services Emergency medical services (EMS) personnel are required to honor a valid DNR order in the event of a medical emergency.
Distribution It is important for individuals to keep a copy of the DNR order in a visible location and provide copies to family members and healthcare providers.

Some Other Do Not Resuscitate Order State Forms

Common mistakes

  1. Failing to complete all required sections of the form. Each section is crucial for ensuring that your wishes are clearly understood.

  2. Not signing the form. A signature is necessary to validate the order and make it legally binding.

  3. Forgetting to date the form. Without a date, it may be unclear when the order was established.

  4. Neglecting to have the form witnessed. The presence of witnesses is often required for the order to be recognized by healthcare providers.

  5. Using outdated versions of the form. Always ensure you have the most current version to avoid legal complications.

  6. Not discussing the order with family members. Communication can prevent confusion and ensure everyone understands your wishes.

  7. Overlooking the need for copies. Keep multiple copies of the signed form in accessible locations to ensure it can be presented when needed.

  8. Misunderstanding the implications of the order. It’s essential to fully comprehend what a Do Not Resuscitate Order entails before signing.

  9. Failing to review the order periodically. Life circumstances change, and so may your wishes regarding resuscitation.

Preview - Florida Do Not Resuscitate Order Form

Florida Do Not Resuscitate (DNR) Order

This Do Not Resuscitate Order is in accordance with the Florida Statutes, Chapter 401.45. It allows qualified individuals to indicate their wish not to receive cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest.

By signing this document, the individual acknowledges their desire to forego resuscitative measures, as outlined below:

  • Patient Name: _____________________________________
  • Date of Birth: _____________________________________
  • Address: _________________________________________
  • City, State, Zip: __________________________________
  • Health Care Proxy/Surrogate Name: ________________
  • Contact Number: __________________________________

The patient or their designated health care proxy must sign below to validate this order:

  • Signature of Patient or Proxy: ____________________________
  • Date: _________________________________________________

Witnesses are required to attest to the signing of this Order:

  1. Witness 1 Name: ___________________________________
  2. Witness 1 Signature: _______________________________
  3. Date: ______________________________________________
  1. Witness 2 Name: ___________________________________
  2. Witness 2 Signature: _______________________________
  3. Date: ______________________________________________

This Order will always be honored by emergency services and health care providers within the state of Florida.