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Homepage ➔ Fillable Do Not Resuscitate Order Form ➔ Attorney-Approved Do Not Resuscitate Order Document for the State of Tennessee
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In Tennessee, the Do Not Resuscitate Order (DNR) form is a crucial document for individuals who wish to express their preferences regarding medical treatment in the event of a life-threatening emergency. This form allows patients to communicate their desire not to receive cardiopulmonary resuscitation (CPR) or other life-saving measures if their heart stops beating or they stop breathing. Understanding how to properly complete and implement this form is essential for ensuring that a person's wishes are respected in critical situations. The DNR form must be signed by a licensed physician, and it is important for individuals to discuss their choices with their healthcare providers and loved ones. Additionally, the form should be easily accessible, as it needs to be presented to emergency medical personnel if a situation arises. By taking the time to fill out this form, individuals can have peace of mind knowing their end-of-life preferences will be honored, allowing them to maintain control over their healthcare decisions during some of life’s most challenging moments.

Consider More Do Not Resuscitate Order Templates for Different States

Whats Dnr Mean - Advance care planning involves a DNR order, ensuring patients' end-of-life wishes are known and respected.

Dnr Paper - It is important for seriously ill patients to have a DNR in place to honor their care choices.

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Dnr Directive - Each individual’s reasons for choosing a DNR can vary widely based on personal circumstances and beliefs.

Dos and Don'ts

When filling out the Tennessee Do Not Resuscitate Order form, it’s crucial to approach the process with care. Here are ten important dos and don’ts to keep in mind:

  • Do ensure you fully understand what a Do Not Resuscitate (DNR) order means before completing the form.
  • Do discuss your wishes with your healthcare provider to ensure clarity and understanding.
  • Do make sure to sign the form in the presence of a witness, as required by Tennessee law.
  • Do keep a copy of the signed form in a safe place and provide copies to your healthcare team.
  • Do review your DNR order periodically, especially if your health status changes.
  • Don't fill out the form in a rush. Take your time to ensure accuracy.
  • Don't forget to include your personal information, such as your name and date of birth.
  • Don't assume that your family members know your wishes without discussing them.
  • Don't leave the form unsigned or incomplete, as this could lead to confusion later.
  • Don't hesitate to seek legal advice if you have questions about the implications of a DNR order.

By following these guidelines, you can ensure that your wishes are respected and understood by your healthcare providers and loved ones.

Tennessee Do Not Resuscitate Order Sample

Tennessee Do Not Resuscitate Order Template

This Do Not Resuscitate (DNR) Order is created in accordance with Tennessee law regarding end-of-life medical decisions. It allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. Please complete the following sections to ensure clarity and understanding of your desires.

Patient Information:

  • Name: ______________________________________
  • Date of Birth: _______________________________
  • Address: ____________________________________
  • City, State, ZIP: ____________________________

Medical Information:

  • Primary Physician's Name: _____________________
  • Primary Physician's Phone Number: ______________

Patient's Wishes:

The patient, named above, has expressed the following wishes regarding resuscitation:

  • I do NOT wish to receive cardiopulmonary resuscitation (CPR) or other life-sustaining treatments in the event of cardiac or respiratory arrest.
  • I understand that this DNR order does not affect other aspects of my medical care.

Signature:

  • Patient's Signature: ____________________________
  • Date: _______________________________________

Witnesses: (Two witnesses are required to validate this DNR order)

  • Witness 1 Name: ________________________________
  • Witness 1 Signature: ___________________________
  • Date: ________________________________________
  • Witness 2 Name: ________________________________
  • Witness 2 Signature: ___________________________
  • Date: ________________________________________

This document is important. Keep it in an accessible location and share your wishes with your family and healthcare providers to ensure they are fulfilled in accordance with your desires.

Listed Questions and Answers

  1. What is a Do Not Resuscitate (DNR) Order in Tennessee?

    A Do Not Resuscitate Order is a medical order that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's heart stops beating or if they stop breathing. In Tennessee, this order is typically used by individuals with serious health conditions or those who wish to avoid aggressive medical interventions at the end of life.

  2. How do I obtain a DNR Order in Tennessee?

    To obtain a DNR Order, you must first discuss your wishes with your physician. If both you and your doctor agree that a DNR is appropriate, your doctor will complete the official DNR form. This form must be signed by the physician and can be presented to emergency medical services and hospitals. It is important to keep a copy of the DNR form in a place where it can be easily accessed by medical personnel.

  3. Can I change or revoke my DNR Order?

    Yes, you can change or revoke your DNR Order at any time. To do this, you should inform your healthcare provider and complete a new DNR form if necessary. Additionally, you can verbally communicate your wishes to your healthcare team. It is crucial to ensure that all copies of the previous DNR Order are destroyed or marked as revoked to prevent any confusion.

  4. Will a DNR Order affect other medical treatments?

    A DNR Order specifically addresses resuscitation efforts and does not affect other medical treatments. You will still receive appropriate medical care for your condition, including pain management and other necessary interventions. It is important to communicate your overall healthcare goals with your medical team to ensure that they understand your preferences beyond the DNR Order.

PDF Characteristics

Fact Name Details
Definition A Do Not Resuscitate (DNR) Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
Governing Law The Tennessee Do Not Resuscitate Order is governed by Tennessee Code Annotated § 68-11-201 et seq.
Eligibility Individuals who are 18 years or older and have the capacity to make medical decisions can complete a DNR Order.
Signature Requirement The DNR Order must be signed by the patient or their legal representative, along with the signature of a physician.
Form Availability The Tennessee DNR Order form is available through healthcare providers, hospitals, and online state resources.
Revocation A DNR Order can be revoked at any time by the patient or their legal representative, and this revocation should be documented.
Emergency Medical Services Emergency Medical Services (EMS) personnel are required to honor a valid DNR Order presented at the scene of a medical emergency.