Homepage Fillable Do Not Resuscitate Order Form Attorney-Approved Do Not Resuscitate Order Document for the State of Florida
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In the state of Florida, the Do Not Resuscitate (DNR) Order form serves as a crucial document for individuals who wish to express their preferences regarding medical treatment in emergency situations. This form is designed for those who, for various reasons, may not want to receive cardiopulmonary resuscitation (CPR) or other life-saving measures if their heart stops beating or they stop breathing. Understanding the implications of this form is essential, as it not only outlines a person's wishes but also provides clarity to healthcare providers and loved ones during critical moments. The DNR Order must be completed and signed by a physician, ensuring that it is a legally recognized directive. It is important to note that this document can be revoked at any time, allowing individuals to change their minds as their circumstances or preferences evolve. By having a DNR Order in place, individuals can take control of their healthcare decisions, ensuring that their values and wishes are respected even when they are unable to communicate them. This article will delve into the key aspects of the Florida DNR Order form, including its purpose, the process of obtaining one, and the significance of discussing these decisions with family and healthcare providers.

Dos and Don'ts

When filling out the Florida Do Not Resuscitate Order form, it’s important to follow certain guidelines to ensure that your wishes are clearly communicated. Here’s a list of things you should and shouldn’t do:

  • Do consult with your healthcare provider to discuss your wishes and understand the implications of the order.
  • Do ensure that you are of sound mind and able to make informed decisions when completing the form.
  • Do sign and date the form in the presence of a witness, as required by Florida law.
  • Do keep a copy of the completed form in a safe place and share it with your family and healthcare providers.
  • Don't use the form if you have not fully discussed your decision with your loved ones and medical team.
  • Don't leave any sections of the form blank, as this could lead to confusion about your wishes.

Florida Do Not Resuscitate Order Sample

Florida Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is made in accordance with Florida State Law. It is a legal document indicating that medical personnel should not perform cardiopulmonary resuscitation (CPR) if the patient stops breathing or their heart stops beating.

Please complete the following sections to ensure your wishes are clearly documented. It is essential to have this form signed in front of a witness to be considered valid.

Patient Information:

  • Name: _______________________________
  • Date of Birth: ________________________
  • Address: _____________________________
  • Phone Number: ________________________

Healthcare Advocate Information:

  • Full Name: ____________________________
  • Relationship to Patient: _______________
  • Contact Number: _______________________

Signatures:

By signing below, you affirm that you understand the contents of this DNR Order and that it reflects your wishes regarding resuscitation:

  1. Patient Signature: _____________________
  2. Date: ________________________________
  3. Witness Signature: ____________________
  4. Date: ________________________________

This document should be kept in an accessible location and provided to your healthcare providers. Review this order periodically to ensure it still reflects your wishes. Your health and peace of mind are of the utmost importance.

Listed Questions and Answers

  1. What is a Florida Do Not Resuscitate Order (DNRO)?

    A Florida Do Not Resuscitate Order is a legal document that allows a person to refuse resuscitation in the event of a cardiac arrest or respiratory failure. It specifically instructs medical personnel not to perform CPR or other life-saving measures. This order is intended for individuals who wish to avoid aggressive medical interventions at the end of life.

  2. Who can request a DNRO?

    A DNRO can be requested by any adult who is capable of making their own medical decisions. This includes individuals diagnosed with a terminal illness, a severe chronic condition, or those who are nearing the end of life. The order must be signed by the patient and their physician.

  3. How do I obtain a DNRO form in Florida?

    You can obtain a Florida DNRO form from various sources. The Florida Department of Health provides a downloadable version on its website. Additionally, healthcare providers, hospitals, and hospice organizations may have copies available. It is important to ensure that the form is the most current version and complies with state requirements.

  4. What information is required on the DNRO form?

    The DNRO form requires specific information, including the patient's name, date of birth, and a statement indicating that the patient does not wish to receive resuscitation. The form must also include the signatures of both the patient and the attending physician. The physician's signature confirms that the patient understands the implications of the order.

  5. Where should I keep my DNRO form?

    It is important to keep the DNRO form in a place that is easily accessible. Many individuals choose to keep it in a visible location, such as on the refrigerator or in a medical file. Additionally, it is advisable to provide copies to family members, caregivers, and healthcare providers to ensure that everyone is aware of the patient’s wishes.

  6. Can a DNRO be revoked or changed?

    Yes, a DNRO can be revoked or changed at any time by the patient. To revoke the order, the patient should destroy the existing DNRO form and inform their healthcare providers of the change. If the patient wishes to create a new DNRO, they must complete and sign a new form with their physician.

  7. What happens if I don’t have a DNRO in place?

    If you do not have a DNRO in place, medical personnel will typically perform resuscitation efforts if you experience cardiac arrest or respiratory failure. This may include CPR, defibrillation, and other life-saving measures. Without a DNRO, your healthcare providers are obligated to act in accordance with standard medical protocols.

PDF Characteristics

Fact Name Description
Definition A Florida Do Not Resuscitate Order (DNRO) is a legal document that allows a person to refuse resuscitation in the event of cardiac or respiratory arrest.
Governing Law The DNRO is governed by Florida Statutes, specifically Section 401.45, which outlines the requirements and procedures for creating and implementing a DNRO.
Eligibility Any adult can complete a DNRO, provided they have the capacity to make medical decisions. This includes individuals with terminal illnesses or severe medical conditions.
Form Requirements The DNRO must be completed and signed by the patient and a physician. The form must also be printed on a specific color paper, typically orange, to ensure visibility.
Storage The completed DNRO should be kept in a prominent location, such as the patient's medical records or at home, to ensure it is readily accessible to medical personnel.
Revocation A DNRO can be revoked at any time by the patient. This can be done verbally or by destroying the form, but it is advisable to notify healthcare providers of the change.
Legal Protections Healthcare providers are protected from liability when they follow a valid DNRO. This means they cannot be sued for not performing resuscitation if the DNRO is in place.