Printable Do Not Resuscitate Order Form for the State of New York

Filling out and using the New York Do Not Resuscitate Order (DNR) form is a significant decision that requires careful consideration. Here are some key takeaways to help you navigate the process:

• The DNR order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if your heart stops or you stop breathing.
• It is essential to discuss your wishes with your healthcare provider and loved ones before completing the form.
• The form must be signed by a licensed physician, nurse practitioner, or physician assistant to be valid.
• You can revoke a DNR order at any time by informing your healthcare provider or by destroying the original document.
• Make sure to carry a copy of the DNR order with you, especially when going to the hospital or any medical facility.
• In New York, the DNR order must be honored by all emergency medical services and hospitals.
• Consider discussing your decision with a legal advisor to ensure that your wishes are clearly understood and documented.

Understanding these points can help you make informed decisions about your healthcare preferences and ensure that your wishes are respected. Remember, it's about your choices and what matters most to you.

A Do Not Resuscitate (DNR) Order form is an important document that outlines a person's wishes regarding resuscitation efforts in the event of a medical emergency. Alongside this form, there are several other documents that may be utilized to ensure a person's healthcare preferences are respected. The following list includes key forms and documents often used in conjunction with a New York DNR Order.

• Health Care Proxy: This document allows an individual to appoint someone to make medical decisions on their behalf if they are unable to do so. The designated person, known as the health care agent, must act in accordance with the individual’s wishes.
• Living Will: A living will is a written statement that specifies an individual's preferences regarding medical treatment in situations where they cannot communicate their wishes. It typically addresses end-of-life care and life-sustaining treatments.
• Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that outlines a patient's preferences for life-sustaining treatments. It is intended for individuals with serious illnesses and is signed by a healthcare provider.
• Advance Directive: An advance directive encompasses both the health care proxy and living will. It serves as a comprehensive guide for healthcare providers regarding an individual's medical preferences and decisions.
• Arizona Agent Form: This crucial document serves as a formal acceptance by the statutory agent in Arizona. For more details, refer to All Arizona Forms.
• Do Not Intubate (DNI) Order: This order specifies that a patient does not wish to be intubated in the event of respiratory failure. It is often used in conjunction with a DNR order.
• Organ Donation Consent Form: This form indicates an individual's wishes regarding organ donation after death. It can be included as part of advance directives to ensure that the person's wishes are honored.
• Medical Power of Attorney: This legal document grants someone the authority to make healthcare decisions on behalf of another person. It is particularly useful when the individual is incapacitated and unable to express their wishes.
• Patient Information Form: This form gathers essential information about the patient, including medical history, allergies, and current medications. It helps healthcare providers make informed decisions about treatment options.
• Emergency Medical Services (EMS) Form: This document is used by emergency responders to quickly access a patient’s DNR status and other critical medical information in emergency situations.

These documents work together to ensure that a person's healthcare preferences are clearly communicated and respected. It is essential for individuals to discuss their wishes with family members and healthcare providers to facilitate understanding and compliance with their desires.

• Advance Directive: This document outlines a person's preferences for medical treatment in situations where they cannot communicate their wishes. Like a Do Not Resuscitate Order, it provides guidance to healthcare providers about the individual's desires regarding life-sustaining measures.
• Living Will: A living will is a type of advance directive that specifically addresses end-of-life care. It details what medical treatments a person does or does not want, similar to how a DNR indicates a preference against resuscitation.
• Durable Power of Attorney for Healthcare: This document designates an individual to make healthcare decisions on behalf of another person. It complements a DNR by ensuring that someone trusted can advocate for the patient’s wishes regarding resuscitation and other treatments.
• Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that outlines a patient's preferences for treatment in emergencies. It is similar to a DNR in that it communicates a person's wishes regarding resuscitation and other life-sustaining measures.
• Healthcare Proxy: This document appoints someone to make medical decisions for an individual if they become incapacitated. It serves a similar purpose to a DNR by ensuring that healthcare decisions align with the patient’s values and preferences.
• Do Not Intubate Order: This order specifically instructs healthcare providers not to insert a breathing tube in the event of respiratory failure. It is akin to a DNR as it reflects a patient's wishes to avoid aggressive life-saving measures.
• Comfort Care Order: This document emphasizes providing comfort and palliative care rather than curative treatments. It aligns with the intent of a DNR by prioritizing quality of life over aggressive interventions.
• Rental Application Form: This document helps potential tenants provide necessary information to landlords, making the rental process smoother for everyone involved. For more details, you can visit https://documentonline.org/blank-rental-application/.
• Withdrawal of Treatment Form: This form allows patients to refuse specific medical treatments. Similar to a DNR, it communicates a patient’s desire to discontinue certain life-sustaining measures.

1. Not discussing the decision with healthcare providers: Many individuals fail to have an open conversation with their doctors or healthcare team before filling out the form. This can lead to misunderstandings about the implications of a Do Not Resuscitate (DNR) order.

2. Incomplete or unclear information: Some people leave sections of the form blank or provide vague responses. This can create confusion about their wishes and potentially lead to unwanted medical interventions.

3. Not signing the form correctly: A common mistake is not signing the DNR order or failing to have the required witnesses sign it. Without proper signatures, the order may not be legally recognized.

4. Forgetting to share the order: After completing the form, individuals often neglect to inform family members and healthcare providers. Without sharing the DNR order, there’s a risk that medical personnel may not be aware of the individual’s wishes during a critical situation.