Homepage Legal Do Not Resuscitate Order Form Blank New York Do Not Resuscitate Order Form

Documents used along the form

A Do Not Resuscitate Order (DNR) form is an important document that allows individuals to express their wishes regarding medical care in emergencies. It is often used alongside other forms to ensure that a person's healthcare preferences are clearly communicated. Below is a list of related documents that may be utilized in conjunction with the DNR form.

  • Health Care Proxy: This document allows an individual to appoint someone else to make medical decisions on their behalf if they become unable to do so. It ensures that a trusted person can advocate for the individual's wishes.
  • Living Will: A living will outlines a person's preferences for medical treatment in situations where they are unable to communicate. It typically covers end-of-life care and other specific medical interventions.
  • Physician Orders for Life-Sustaining Treatment (POLST): This form provides specific medical orders regarding treatment preferences. It is often used for individuals with serious health conditions to ensure their wishes are honored by healthcare providers.
  • Advance Directive: An advance directive is a general term for documents that outline a person's healthcare wishes. It can include both a living will and a health care proxy.
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  • Do Not Intubate (DNI) Order: Similar to a DNR, a DNI order specifically states that a person does not wish to be intubated or placed on a ventilator in the event of respiratory failure.
  • Comfort Care Order: This document outlines a preference for palliative care, focusing on comfort rather than aggressive treatment. It is designed for individuals who prioritize quality of life over prolonged medical interventions.
  • Emergency Medical Services (EMS) Form: This form provides guidance to emergency responders about a person's medical preferences during emergencies. It is crucial for ensuring that wishes are respected in urgent situations.

These documents work together to create a comprehensive plan for medical care and ensure that individual preferences are respected. Having these forms in place can help ease the decision-making process for family members and healthcare providers during critical times.

Similar forms

The New York Do Not Resuscitate (DNR) Order form shares similarities with an Advance Directive. An Advance Directive is a legal document that outlines an individual’s preferences for medical treatment in case they become unable to communicate those wishes. Both documents serve to express a person's desires regarding end-of-life care, ensuring that healthcare providers respect their choices. While the DNR specifically addresses resuscitation efforts, the Advance Directive can cover a broader range of medical decisions.

Another document similar to the DNR is the Physician Orders for Life-Sustaining Treatment (POLST) form. The POLST form translates a patient's wishes regarding life-sustaining treatments into actionable medical orders. Like the DNR, it is designed for individuals with serious health conditions and provides clear instructions to healthcare providers. The POLST form goes further by addressing various treatment options, whereas the DNR focuses solely on resuscitation.

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The Living Will is also akin to the DNR Order form. A Living Will is a written statement that specifies a person's wishes regarding medical treatment in situations where they cannot express their preferences. Both documents emphasize the importance of patient autonomy and ensure that healthcare providers follow the individual’s wishes. However, a Living Will can cover a wider array of medical interventions beyond just resuscitation.

A Medical Power of Attorney (POA) is another document that shares similarities with the DNR. A Medical POA allows an individual to designate someone else to make healthcare decisions on their behalf if they become incapacitated. While the DNR provides specific instructions about resuscitation, the Medical POA grants broader authority to the appointed person to make decisions based on the patient's wishes, including those articulated in a DNR.

The Do Not Hospitalize (DNH) order is also related to the DNR. A DNH order is a directive that instructs healthcare providers not to transfer a patient to a hospital for treatment. Both documents focus on respecting the patient’s wishes regarding their care, particularly in end-of-life situations. However, the DNH specifically addresses hospitalization, while the DNR centers on resuscitation efforts.

Similar to the DNR is the Comfort Care Order, which emphasizes providing comfort rather than curative treatment. This document instructs healthcare providers to prioritize pain relief and comfort measures over aggressive interventions. Both the Comfort Care Order and the DNR reflect a patient’s desire for a peaceful end-of-life experience, focusing on quality of life rather than prolonging it through medical interventions.

The Healthcare Proxy is another document that aligns with the DNR. A Healthcare Proxy designates an individual to make medical decisions on behalf of someone who is unable to do so. While the DNR provides specific instructions about resuscitation, the Healthcare Proxy empowers a trusted person to interpret and act on the patient’s wishes, which may include the directives outlined in the DNR.

The No Code Order is similar to the DNR in that it explicitly states that no resuscitation efforts should be made in the event of cardiac or respiratory arrest. Both documents aim to communicate a patient’s wishes regarding resuscitation. The No Code Order may be used interchangeably with the DNR in many healthcare settings, reinforcing the importance of respecting a patient’s end-of-life decisions.

Lastly, the End-of-Life Care Plan is comparable to the DNR as it outlines a patient’s preferences for care during their final days. This document may include wishes about resuscitation, pain management, and other aspects of end-of-life care. Both the End-of-Life Care Plan and the DNR emphasize the importance of honoring the patient’s choices and ensuring that their desires are respected by healthcare providers.

Steps to Filling Out New York Do Not Resuscitate Order

Completing the New York Do Not Resuscitate Order form is an important step for individuals who wish to express their preferences regarding medical treatment in emergency situations. After filling out this form, it should be signed and dated. Make sure to provide copies to your healthcare provider and keep one for your records. Here are the steps to fill out the form:

  1. Obtain the New York Do Not Resuscitate Order form. You can find this form online or request it from your healthcare provider.
  2. Fill in your full name, date of birth, and any other personal information required at the top of the form.
  3. Indicate your wishes regarding resuscitation by checking the appropriate box. This typically includes options for "Do Not Resuscitate" or "Allow Resuscitation."
  4. Provide the name of your healthcare proxy, if you have one. This person will make medical decisions on your behalf if you are unable to do so.
  5. Sign and date the form in the designated area. Your signature is necessary to validate your wishes.
  6. Have your healthcare provider or a witness sign the form, if required. This step may depend on specific guidelines.
  7. Make copies of the completed form for your records and to share with your healthcare provider.

After completing these steps, ensure that the form is stored in a safe place where it can be easily accessed when needed. It is also wise to discuss your wishes with family members and healthcare professionals to ensure everyone understands your preferences.