Attorney-Verified Do Not Resuscitate Order Form for California

The California Do Not Resuscitate (DNR) Order form is a crucial document that outlines a patient's wishes regarding resuscitation efforts in the event of cardiac or respiratory arrest. Alongside this form, several other documents can play a significant role in ensuring that a patient's healthcare preferences are honored. Below is a list of commonly used forms and documents that complement the DNR Order.

• Advance Healthcare Directive: This document allows individuals to specify their healthcare preferences and appoint a healthcare agent to make decisions on their behalf if they become unable to communicate.
• Billing Statement Management: Utilizing a streamlined process for invoicing can enhance clarity and efficiency in billing practices, such as adopting a Statement Template for better documentation.
• Physician Orders for Life-Sustaining Treatment (POLST): The POLST form translates a patient's treatment preferences into actionable medical orders, guiding healthcare providers in emergencies.
• Living Will: A living will outlines a person's wishes regarding medical treatment in scenarios where they are terminally ill or permanently unconscious, providing clarity on end-of-life care.
• Health Care Proxy: This document designates a trusted individual to make healthcare decisions for someone who is incapacitated, ensuring that personal values and preferences are respected.
• Do Not Intubate (DNI) Order: Similar to a DNR, this order specifically indicates that a patient does not wish to be intubated or placed on a mechanical ventilator during a medical emergency.
• Medication Administration Record (MAR): This form tracks all medications administered to a patient, ensuring that healthcare providers are aware of current treatments and can make informed decisions.
• Patient Information Form: This document collects essential details about the patient, including medical history and current medications, which can aid healthcare providers in delivering appropriate care.
• Emergency Contact Information: A simple yet vital document, it lists individuals to be contacted in case of an emergency, ensuring that family or friends can be informed and involved in critical decisions.

These documents work together to create a comprehensive approach to patient care, facilitating communication between patients, families, and healthcare providers. By having these forms in place, individuals can ensure that their healthcare preferences are respected, even in challenging circumstances.

• Advance Directive: This document outlines a person's wishes regarding medical treatment in situations where they cannot communicate their preferences. Like a DNR, it helps ensure that medical care aligns with an individual's values and desires.

• Living Will: A living will specifies what types of medical treatment a person does or does not want at the end of life. It serves a similar purpose to a DNR by guiding healthcare providers in critical situations.

• Power of Attorney for Healthcare: This document designates someone to make healthcare decisions on behalf of an individual if they become incapacitated. It complements a DNR by allowing a trusted person to advocate for the patient's wishes.

• Texas Motor Vehicle Power of Attorney: This form allows you to designate someone to handle vehicle-related tasks, ensuring efficient management of your vehicle affairs. For a convenient option, consider using Fillable Forms.

• Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that outlines a patient's preferences for treatment in emergencies. It is more detailed than a DNR and is designed to be honored by medical personnel.

• Healthcare Proxy: A healthcare proxy appoints an individual to make medical decisions for someone who cannot do so themselves. This document works in tandem with a DNR to ensure that a person's healthcare wishes are respected.

• Do Not Intubate Order: Similar to a DNR, a Do Not Intubate order specifically instructs healthcare providers not to use intubation to assist with breathing. It reflects a patient's wishes regarding a specific aspect of life-sustaining treatment.

• Comfort Care Order: This order focuses on providing comfort rather than aggressive treatment. It aligns with a DNR in that both prioritize quality of life over life extension in certain medical situations.

• End-of-Life Care Plan: An end-of-life care plan outlines a person's preferences for care as they approach the end of their life. It can include elements similar to a DNR, ensuring that their wishes are clear and respected.

• Organ Donation Consent: While not directly similar, this document expresses a person's wishes regarding organ donation after death. It complements a DNR by addressing another aspect of end-of-life decisions.

• Patient Bill of Rights: This document outlines the rights of patients regarding their medical care. While it does not directly dictate treatment preferences, it supports the principles behind a DNR by emphasizing patient autonomy and informed consent.

When filling out the California Do Not Resuscitate (DNR) Order form, it is essential to approach the process with care and clarity. Below is a list of things to do and avoid to ensure that the form accurately reflects your wishes.

• Do consult with your healthcare provider before completing the form to understand its implications.
• Do ensure that the form is signed by you and a witness, as required by California law.
• Do keep a copy of the completed form for your records and provide copies to your healthcare team.
• Do discuss your decision with family members to ensure they understand your wishes.

• Don't fill out the form without fully understanding what a DNR order entails.
• Don't sign the form if you feel pressured or uncertain about your decision.
• Don't forget to review and update the form periodically, especially if your health status changes.
• Don't assume that verbal instructions will suffice; a written order is necessary for it to be honored.

1. Not discussing the decision with family or loved ones. It’s important to communicate your wishes with those who may be involved in your care. This helps prevent confusion and ensures everyone understands your choices.

2. Failing to sign the form. A signature is required for the Do Not Resuscitate Order to be valid. Without it, the document may not hold any legal weight.

3. Not having the form witnessed. California law requires that the form be signed in the presence of a witness. Not following this step can invalidate the order.

4. Using outdated forms. Always ensure you are using the most current version of the Do Not Resuscitate Order form. Older versions may not be recognized by healthcare providers.

5. Leaving out important information. Complete all sections of the form. Missing details can lead to misunderstandings about your wishes.

6. Not providing copies to relevant parties. After filling out the form, share copies with your healthcare providers, family members, and anyone else who may need to know your wishes.

7. Overlooking state-specific requirements. Each state has its own rules regarding Do Not Resuscitate Orders. Be sure to follow California's specific guidelines to ensure the order is valid.

8. Not reviewing the order regularly. Life circumstances can change. Regularly reviewing your Do Not Resuscitate Order ensures it still reflects your current wishes.

9. Ignoring the need for a healthcare proxy. Consider appointing someone to make healthcare decisions on your behalf if you cannot. This person can help ensure your wishes are honored.