Homepage Attorney-Approved Do Not Resuscitate Order Template Attorney-Approved Do Not Resuscitate Order Document for the State of Florida
Outline

In the state of Florida, the Do Not Resuscitate Order (DNRO) form serves as a crucial tool for individuals who wish to make their healthcare preferences known in the event of a medical emergency. This legally binding document allows patients to refuse cardiopulmonary resuscitation (CPR) and other life-saving measures if their heart stops or they stop breathing. It is essential for patients to understand that the DNRO form must be completed and signed by a physician, ensuring that their wishes are respected by medical personnel. The form is typically printed on bright yellow paper, making it easily identifiable in emergency situations. Additionally, it is important for individuals to discuss their decisions with family members and healthcare providers to ensure everyone is on the same page regarding their end-of-life wishes. By having a DNRO in place, patients can maintain control over their medical care and ensure that their preferences are honored when they may not be able to communicate them themselves.

Sample - Florida Do Not Resuscitate Order Form

Florida Do Not Resuscitate Order Template

This Do Not Resuscitate (DNR) Order is created in accordance with Florida Statutes, Chapter 401. It is essential for individuals who wish to express their preference regarding resuscitation in the event of a medical emergency.

Please fill in the following information:

  • Patient's Full Name: ____________________________
  • Date of Birth: ____________________________
  • Patient's Address: ____________________________
  • City, State, Zip Code: ____________________________
  • Patient's Phone Number: ____________________________
  • Healthcare Proxy Name: ____________________________
  • Healthcare Proxy Phone Number: ____________________________

The undersigned hereby states that the above-named patient has a terminal condition or is in a persistent vegetative state. The patient has expressed a desire not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest. This order shall remain in effect until revoked by the patient or the patient's legally authorized representative.

Signature of Patient or Authorized Representative: ____________________________

Date: ____________________________

Witness Signature: ____________________________

Date: ____________________________

Note: This document must be signed by the patient or an authorized representative and witnessed by two adults who are not related to the patient or entitled to any portion of the patient's estate.

File Characteristics

Fact Name Description
Definition A Florida Do Not Resuscitate Order (DNRO) is a legal document that allows a person to refuse resuscitation in case of cardiac or respiratory arrest.
Governing Law The DNRO is governed by Florida Statutes, specifically Chapter 401.45.
Eligibility Any adult can create a DNRO, provided they are of sound mind and understand the implications of the order.
Signature Requirements The form must be signed by the individual or their legal representative and witnessed by two adults who are not related.
Form Availability The Florida DNRO form is available online and can be printed for use.
Healthcare Provider Role Healthcare providers are required to honor a valid DNRO, ensuring the individual's wishes are respected.
Revocation A DNRO can be revoked at any time by the individual, verbally or in writing.
Emergency Medical Services Emergency medical services personnel must verify the DNRO before withholding resuscitation efforts.
Legal Protections Individuals who complete a DNRO are protected from legal liability when their wishes are followed by medical personnel.

Detailed Guide for Filling Out Florida Do Not Resuscitate Order

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

  1. Obtain the Florida Do Not Resuscitate Order form. You can find it online or request it from your healthcare provider.
  2. Start with the top section. Enter your full name, date of birth, and address in the designated fields.
  3. Indicate the date you are completing the form. This is important for record-keeping purposes.
  4. Next, you will need to check the appropriate box to indicate whether you want a Do Not Resuscitate Order.
  5. Sign the form at the bottom. Your signature confirms that you understand and agree to the order.
  6. Have a witness sign the form. The witness must be an adult who is not related to you or your healthcare provider.
  7. Make copies of the completed form for your records and to share with your healthcare providers.

After filling out the form, keep it in a safe but accessible place. Share it with your family and healthcare team to ensure your wishes are known and respected.

Obtain Answers on Florida Do Not Resuscitate Order

  1. What is a Florida Do Not Resuscitate Order (DNRO)?

    A Florida Do Not Resuscitate Order is a legal document that allows a person to refuse resuscitation efforts in the event of a medical emergency. This includes interventions such as cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS). The order is intended for individuals who are facing terminal illnesses or who wish to avoid aggressive medical interventions at the end of life.

  2. Who can complete a DNRO in Florida?

    In Florida, any adult who is of sound mind can complete a Do Not Resuscitate Order. This includes individuals who are dealing with serious health conditions or those who simply wish to express their end-of-life preferences. Additionally, a legal guardian or healthcare surrogate can also sign the DNRO on behalf of an individual who is unable to do so.

  3. How do I obtain a DNRO form in Florida?

    The DNRO form can be obtained from various sources, including:

    • Healthcare providers, such as hospitals or doctors' offices.
    • The Florida Department of Health website, which provides downloadable forms.
    • Legal aid organizations that assist with end-of-life planning.

    Once you have the form, it is essential to fill it out accurately and completely to ensure that your wishes are respected.

  4. What should I do with the completed DNRO form?

    After completing the DNRO form, it is important to keep it in a location that is easily accessible. You should provide copies to your healthcare provider, family members, and anyone involved in your care. Additionally, consider placing a copy in your medical records. This ensures that your wishes are known and can be followed in a medical emergency.

  5. Can I change or revoke my DNRO at any time?

    Yes, you can change or revoke your Do Not Resuscitate Order at any time. If you decide to do so, it is crucial to inform your healthcare provider and anyone else who has a copy of the original form. To revoke the DNRO, you may simply destroy the existing document and communicate your new wishes clearly to your care team and family members.

Common mistakes

Filling out the Florida Do Not Resuscitate (DNR) Order form is a significant step for individuals who wish to make their healthcare preferences known. However, many people make mistakes that can lead to confusion or even unintended consequences. One common error is failing to provide all required information. The form asks for specific details, including the patient’s name, date of birth, and signature. Omitting any of this critical information can render the document invalid.

Another mistake often seen is not having the form properly signed by the patient or their legal representative. A DNR order must be signed to be legally binding. If the document is unsigned, healthcare providers may not honor the wishes outlined in the form. It’s essential to ensure that the signature is present and that it matches the name on the form.

People also sometimes overlook the importance of discussing their DNR wishes with family members and healthcare providers. Without clear communication, loved ones may be unaware of the patient's intentions, leading to conflict during a medical emergency. It’s advisable to have open conversations about end-of-life preferences to ensure everyone is on the same page.

Finally, individuals might forget to review and update their DNR orders as their health status changes. A DNR order should reflect the current wishes of the patient. If a person’s condition improves or their preferences change, it’s crucial to revise the form accordingly. Regularly checking the document helps ensure that it aligns with the individual’s current desires.

Documents used along the form

The Florida Do Not Resuscitate Order (DNRO) form is an important document for individuals who wish to express their wishes regarding resuscitation efforts in case of a medical emergency. Alongside this form, there are several other documents that can help clarify medical preferences and ensure that healthcare providers understand a person's wishes. Here’s a list of some commonly used forms:

  • Advance Directive: This document outlines an individual’s preferences for medical treatment in the event they become unable to communicate their wishes. It can include decisions about life-sustaining treatments and end-of-life care.
  • Living Will: A type of advance directive, a living will specifically details what types of medical treatment a person does or does not want in situations where they are terminally ill or permanently unconscious.
  • Healthcare Power of Attorney: This form allows a person to appoint someone else to make healthcare decisions on their behalf if they are unable to do so. It ensures that a trusted individual can advocate for their wishes.
  • Physician Orders for Life-Sustaining Treatment (POLST): This document provides specific medical orders based on a patient’s preferences for treatment. It is intended for individuals with serious illnesses and is signed by a physician.
  • Do Not Intubate (DNI) Order: This is a specific order that indicates a patient does not want to be intubated if they experience respiratory failure. It complements the DNRO by addressing another aspect of medical intervention.
  • Patient Advocate Designation: This form allows a person to designate an advocate who can make healthcare decisions on their behalf. It can be useful in ensuring that someone understands and respects their wishes.
  • Emergency Medical Services (EMS) Directive: This document provides guidance to emergency medical personnel regarding a person's wishes for treatment in emergency situations, ensuring that their preferences are honored.
  • Organ Donation Form: This form allows individuals to express their wishes regarding organ donation after death. It can be included with other advance directives to clarify intentions about organ donation.
  • Do Not Hospitalize (DNH) Order: This order indicates that a patient does not wish to be admitted to a hospital for treatment, focusing on comfort care instead. It is particularly relevant for those with terminal conditions.

Having these documents in place can provide peace of mind for individuals and their families. They help ensure that medical wishes are respected and understood, making difficult situations a little easier to navigate.

Similar forms

The Do Not Resuscitate (DNR) Order form is an important document in healthcare that outlines a patient's wishes regarding resuscitation efforts in the event of cardiac arrest or respiratory failure. Several other documents serve similar purposes in expressing medical preferences or end-of-life care decisions. Here are six documents that share similarities with the DNR Order form:

  • Living Will: This document allows individuals to specify their preferences for medical treatment in situations where they may be unable to communicate. Like a DNR, it addresses end-of-life care but can cover a broader range of medical interventions.
  • Healthcare Power of Attorney: This legal document designates a person to make medical decisions on behalf of an individual if they are incapacitated. Similar to a DNR, it ensures that a person's healthcare wishes are respected, especially in critical situations.
  • Physician Orders for Life-Sustaining Treatment (POLST): POLST forms provide specific medical orders regarding treatment preferences. They are similar to DNRs but are more comprehensive, detailing various interventions a patient may or may not want.
  • Advance Directive: This is a broader term that encompasses both living wills and healthcare powers of attorney. It outlines a person's wishes regarding medical treatment and can include DNR instructions, making it a comprehensive planning tool.
  • Do Not Intubate (DNI) Order: This document specifically instructs healthcare providers not to insert a breathing tube in the event of respiratory failure. It is similar to a DNR in that it outlines a patient's wishes regarding life-sustaining measures.
  • Comfort Care Order: This order focuses on providing comfort rather than curative treatments. It aligns with the principles of a DNR by emphasizing quality of life and minimizing invasive procedures in end-of-life situations.

Each of these documents plays a crucial role in ensuring that individuals' healthcare preferences are honored, especially during critical moments when they may not be able to voice their wishes.

Dos and Don'ts

When filling out the Florida Do Not Resuscitate Order (DNRO) form, it is crucial to approach the process with care and clarity. Here are six important dos and don'ts to consider:

  • Do ensure that you fully understand the implications of a DNRO. This document indicates that you do not wish to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  • Do consult with a healthcare professional. Discuss your wishes and health status to make informed decisions.
  • Do complete the form in its entirety. Missing information can lead to confusion and may not be honored by medical personnel.
  • Do sign and date the form. Your signature validates your wishes and ensures that the document is legally binding.
  • Don't fill out the form under pressure. Take your time to consider your choices and discuss them with loved ones.
  • Don't forget to provide copies of the completed form to your healthcare providers and family members. This ensures everyone is aware of your wishes.

Misconceptions

Understanding the Florida Do Not Resuscitate (DNR) Order can be challenging, and several misconceptions often arise. Let's clarify some common misunderstandings surrounding this important document.

  • A DNR order means you will not receive any medical care. This is not true. A DNR order specifically addresses resuscitation efforts in the event of cardiac arrest. It does not prevent you from receiving other types of medical treatment or care.
  • You can only get a DNR order if you are terminally ill. This misconception can lead to confusion. While many people associate DNR orders with terminal illnesses, anyone can request one, regardless of their health status. It’s a personal choice based on individual preferences regarding end-of-life care.
  • A DNR order is the same as a living will. While both documents relate to healthcare decisions, they serve different purposes. A living will outlines your wishes regarding medical treatment in situations where you cannot communicate, whereas a DNR order specifically instructs healthcare providers not to perform resuscitation.
  • A DNR order can be verbal. This is a common misunderstanding. In Florida, a DNR order must be documented in writing and signed by a physician. Verbal requests do not hold legal weight and cannot be acted upon in an emergency.

Being informed about these misconceptions can help you make better decisions regarding your healthcare preferences. Always consult with a healthcare professional when considering a DNR order or any other advance directive.

Key takeaways

Understanding the Florida Do Not Resuscitate Order (DNRO) form is crucial for individuals wishing to express their healthcare preferences. Here are key takeaways to consider:

  • The DNRO form allows individuals to refuse resuscitation efforts in the event of a cardiac or respiratory arrest.
  • It must be signed by a licensed physician to be valid.
  • Individuals should discuss their wishes with family and healthcare providers before completing the form.
  • The form should be readily accessible, ideally kept in a visible location, such as on the refrigerator or in a medical file.
  • It is important to review and update the DNRO as personal health situations or preferences change.
  • Healthcare providers are legally required to honor the DNRO once it is properly completed and signed.
  • Individuals can revoke the DNRO at any time, provided they communicate their decision clearly.

Being informed about the DNRO process ensures that your healthcare wishes are respected and followed. Take the time to understand and complete the form properly.