Free Do Not Resuscitate Order Form for Florida
Article Map
Preview - Florida Do Not Resuscitate Order Form
Florida Do Not Resuscitate Order Template
This Do Not Resuscitate (DNR) Order is in accordance with Florida state law (Chapter 401.45, Florida Statutes). Please complete the sections below to ensure your wishes are documented clearly.
Patient Information:
- Patient Name: _____________________________
- Date of Birth: _____________________________
- Address: _____________________________
- City, State, Zip Code: _____________________________
Health Care Proxy Information:
- Name: _____________________________
- Relationship: _____________________________
- Phone Number: _____________________________
DNR Order Statement:
In accordance with my wishes regarding medical treatment, I do not wish to receive cardiopulmonary resuscitation (CPR) or advanced cardiac life support if I suffer a cardiac or respiratory arrest.
Signature and Consent:
By signing below, I confirm that this DNR order reflects my wishes regarding resuscitation efforts. I authorize the healthcare professionals to follow this order in case of an emergency.
Signature of Patient: _____________________________
Date: _____________________________
Witness Information:
- Name: _____________________________
- Signature: _____________________________
- Date: _____________________________
This document should be kept in a prominent location and shared with your healthcare providers to ensure your wishes are known.
Create Other Common Do Not Resuscitate Order Forms for Different States
Dnr Cca Meaning - A DNR order can alleviate confusion among emergency responders in critical situations.
Out of Hospital Dnr Texas - Being informed about the options and implications of a DNR order empowers patients to advocate for their healthcare preferences.
Is a Dnr an Advance Directive - Families should discuss DNR requests with healthcare providers to ensure understanding.
When engaging in the sale of a motorcycle in Pennsylvania, it's crucial to complete the Pennsylvania Motorcycle Bill of Sale, which serves as the legal record of ownership transfer. This document not only provides proof of purchase and transaction details but also protects the interests of both parties involved. For further details on the necessary documentation, you can refer to Auto Bill of Sale Forms, which guide you through the essential steps of the process.
Can a Medical Power of Attorney Override a Dnr - Helps ensure that medical decisions align with a person’s values and beliefs regarding life support.
Similar forms
- Advance Directive: This document outlines an individual'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 person’s desires regarding life-sustaining treatments.
- Living Will: A living will is a type of advance directive that specifically addresses the types of medical treatment a person wants or does not want at the end of life. Similar to a DNR, it helps ensure that a person's wishes are respected during critical health situations.
- Durable Power of Attorney for Healthcare: This document allows an individual to appoint someone else to make medical decisions on their behalf if they are unable to do so. It can include preferences similar to those in a DNR, ensuring that the appointed person understands the individual’s wishes.
- POLST (Physician Orders for Life-Sustaining Treatment): A POLST form translates a patient’s preferences into actionable medical orders. Like a DNR, it is intended for individuals with serious illnesses and is designed to be honored by healthcare providers.
- Healthcare Proxy: Similar to a durable power of attorney, a healthcare proxy designates someone to make medical decisions for a person if they become incapacitated. This document can reflect the same wishes as a DNR, guiding the proxy in their decision-making.
- Do Not Intubate Order: This order specifically instructs healthcare providers not to place a breathing tube in the event of respiratory failure. It is closely related to a DNR, as both documents express a desire to avoid aggressive life-saving measures.
- Florida Lady Bird Deed: For those considering estate planning, the flexible Florida Lady Bird Deed options provide an efficient way to transfer property while retaining certain rights during the owner's lifetime.
- Comfort Care Order: This document focuses on providing comfort rather than curative treatment. It aligns with the principles of a DNR by emphasizing the quality of life and the desire to avoid unnecessary interventions.