Attorney-Approved Pennsylvania Do Not Resuscitate Order Form

Instructions on How to Fill Out Pennsylvania Do Not Resuscitate Order

Filling out the Pennsylvania Do Not Resuscitate Order form is a straightforward process. This document allows individuals to express their wishes regarding resuscitation in the event of a medical emergency. Follow these steps carefully to ensure the form is completed correctly.

1. Obtain the Pennsylvania Do Not Resuscitate Order form. You can find it online or request a copy from your healthcare provider.
2. Read the instructions on the form thoroughly before starting to fill it out.
3. Fill in your full name and date of birth in the designated areas.
4. Indicate your wishes regarding resuscitation by checking the appropriate box. Make sure to consider your preferences carefully.
5. Sign and date the form at the bottom. This step is crucial, as it validates your request.
6. Have your physician sign the form. Their signature is necessary for the document to be legally recognized.
7. Make copies of the completed form for your records and share it with your healthcare provider and family members.

Once you have completed the form, ensure that it is stored in an accessible location. Inform your family and healthcare team about your decision, so they can honor your wishes in a medical emergency.

Filling out a Do Not Resuscitate (DNR) Order form in Pennsylvania is an important step in making your healthcare wishes known. Here are some key takeaways to consider:

• The DNR Order allows you to refuse resuscitation efforts in case of cardiac or respiratory arrest.
• This form must be signed by a physician to be valid.
• It is essential to discuss your wishes with your healthcare provider before filling out the form.
• You can change or revoke your DNR Order at any time if your wishes change.
• Make sure to keep the DNR Order in a visible place, such as on your refrigerator or in your medical records.
• Inform your family members and caregivers about your DNR Order so they understand your wishes.
• The DNR Order is specific to Pennsylvania; other states may have different forms or requirements.
• Emergency medical personnel are trained to recognize and follow DNR Orders.
• Having a DNR Order does not affect the quality of care you receive for other medical issues.
• Consider consulting with a legal or healthcare professional for guidance on completing the form.

Understanding these points can help ensure that your healthcare preferences are respected and followed in critical situations.

When dealing with end-of-life care decisions in Pennsylvania, several documents complement the Do Not Resuscitate (DNR) Order form. These documents help clarify a person's wishes regarding medical treatment and ensure that healthcare providers understand and respect those wishes. Below is a list of commonly used forms and documents.

• Advance Directive: This document outlines a person's preferences for medical treatment in situations where they cannot communicate their wishes. It often includes instructions about life-sustaining treatments.
• Healthcare Power of Attorney: This form designates a specific individual to make healthcare decisions on behalf of a person if they become unable to do so themselves.
• 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.
• Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that outlines a patient's preferences for treatments, including resuscitation, and is signed by a physician.
• Do Not Intubate (DNI) Order: This order specifies that a patient should not be intubated if they stop breathing or their heart stops, complementing a DNR order.
• Organ Donation Consent: This document expresses an individual’s wishes regarding organ donation after death, ensuring that their intentions are honored.
• Emergency Medical Services (EMS) DNR Form: This form is specifically for use by EMS personnel, indicating that resuscitation should not be attempted in an emergency situation.
• Patient's Rights Document: This outlines the rights of patients regarding their medical care and treatment options, ensuring they are informed and respected.
• Medical History Form: This form provides healthcare providers with essential information about a patient’s medical history, allergies, and current medications.

These documents work together to ensure that an individual's healthcare preferences are understood and respected. It is crucial to have these forms completed and shared with relevant parties to facilitate clear communication about end-of-life care wishes.

When filling out the Pennsylvania Do Not Resuscitate (DNR) Order form, it is crucial to approach the process with care and attention. The following list outlines key actions to take and avoid.

• Do ensure you understand the implications of a DNR order before completing the form.
• Do consult with a healthcare professional to discuss your wishes and any medical conditions.
• Do provide accurate personal information, including the patient's name and date of birth.
• Do sign and date the form in the appropriate sections.
• Don't fill out the form under pressure or without fully understanding its consequences.
• Don't forget to inform family members and healthcare providers about the DNR order.
• Don't use outdated forms; always ensure you are using the most current version.
• Don't neglect to keep copies of the signed DNR order in accessible locations.

By following these guidelines, individuals can ensure that their wishes regarding resuscitation are clearly communicated and respected.