PDF Forms
Homepage >> Valid Do Not Resuscitate Order Template >> Printable Do Not Resuscitate Order Form for the State of North Carolina
Content Navigation

In North Carolina, the Do Not Resuscitate (DNR) Order form serves as a critical document for individuals who wish to express their preferences regarding resuscitation efforts in the event of a medical emergency. This form is particularly significant for patients with terminal illnesses or those who have a limited quality of life. It allows them to communicate their wishes clearly to healthcare providers, ensuring that their choices are respected. The DNR Order must be signed by a physician and the patient or their legal representative, and it is important to understand that it only applies in specific situations where the patient is not breathing or their heart has stopped. Additionally, the form should be readily accessible to emergency medical personnel and healthcare providers, as its presence can guide life-saving measures. Understanding the implications and requirements of the DNR Order is essential for both patients and their families, as it facilitates informed decision-making during challenging times.

Check out Other Common Do Not Resuscitate Order Templates for Different States

Georgia Dnr Form - It's crucial to update the Do Not Resuscitate Order if there are significant changes in the patient's health status.

A properly executed Motor Vehicle Bill of Sale form is essential for facilitating a smooth vehicle transfer, as it outlines the various aspects of the transaction. For those seeking a reliable template for this purpose, you can find a fillable version at smarttemplates.net/fillable-motor-vehicle-bill-of-sale, which helps ensure all necessary details are captured for clarity and security.

How to Get a Dnr Form - DNR orders can be a comfort for individuals who wish to die naturally without intensive medical interventions.

Documents used along the form

In addition to the North Carolina Do Not Resuscitate Order (DNR) form, several other documents are commonly used to ensure a person's healthcare preferences are respected. These documents help clarify medical decisions and provide guidance to healthcare providers and family members.

  • Advance Directive: This document outlines a person's wishes regarding medical treatment in situations where they cannot communicate their preferences. It may include instructions about life-sustaining treatments and appoints a healthcare proxy to make decisions on their behalf.
  • Living Will: A living will specifies the types of medical treatments a person does or does not want in the event of a terminal illness or incapacitation. It focuses on end-of-life care and can guide healthcare providers in critical situations.
  • Ca DMV DL 44 Form: This essential application is required for obtaining a driver's license or identification card in California, encompassing new applications, renewals, and changes such as name corrections. For more information, visit All California Forms.
  • Healthcare Power of Attorney: This legal document designates an individual to make healthcare decisions for someone else if they become unable to do so. The appointed person acts according to the wishes expressed by the individual in their advance directive or living will.
  • Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that reflects a patient's wishes regarding treatment preferences. It is designed for individuals with serious illnesses and must be signed by a healthcare provider to be valid.

These documents work together to provide clear guidance on a person's healthcare choices. They ensure that medical decisions align with individual values and preferences, especially during critical times.

PDF Overview

Fact Name Details
Definition A Do Not Resuscitate (DNR) Order is a medical order that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's heart stops or if they stop breathing.
Eligibility Any adult who is capable of making their own medical decisions can request a DNR Order in North Carolina.
Governing Law The North Carolina Do Not Resuscitate Order is governed by North Carolina General Statutes § 90-321 through § 90-325.
Form Requirements The DNR Order must be signed by a physician and the patient or their legal representative.
Validity The DNR Order is valid across all healthcare settings in North Carolina, including hospitals, nursing homes, and home care.
Revocation A patient can revoke a DNR Order at any time. This can be done verbally or by destroying the form.

More About North Carolina Do Not Resuscitate Order

What is a Do Not Resuscitate (DNR) Order in North Carolina?

A Do Not Resuscitate Order is a legal document that allows a person to refuse resuscitation efforts in the event of cardiac arrest or respiratory failure. In North Carolina, this order is typically signed by a physician and reflects the patient's wishes regarding emergency medical treatment. It is important to have this document in place if you have specific preferences about your medical care at the end of life.

Who can request a DNR Order in North Carolina?

In North Carolina, a DNR Order can be requested by a patient who is at least 18 years old and is capable of making informed decisions about their health care. If the patient is unable to make decisions, a legally authorized representative, such as a family member or designated health care agent, may request the order on their behalf. It is crucial that the request accurately reflects the patient’s wishes and is discussed with a healthcare provider.

How is a DNR Order implemented in a medical setting?

Once a DNR Order is signed by a physician, it must be readily available to medical personnel. This typically means that it should be placed in the patient's medical record or visibly displayed in their living space, such as on the refrigerator or bedside. Emergency medical services and hospital staff are trained to respect DNR Orders. However, it is advisable to communicate your wishes clearly to family members and caregivers to ensure everyone is aware of the order.

Can a DNR Order be revoked or changed?

Yes, a DNR Order can be revoked or changed at any time by the patient or their authorized representative. This can be done verbally or in writing. If the order is revoked, it is important to inform all healthcare providers and ensure that the previous DNR documentation is removed from the patient’s medical records. Keeping an open line of communication with healthcare providers is essential to ensure that your current wishes are understood and respected.

North Carolina Do Not Resuscitate Order: Usage Steps

Filling out the North Carolina Do Not Resuscitate Order form is a crucial step for individuals who wish to express their preferences regarding medical treatment in emergency situations. It is important to ensure that the form is completed accurately to reflect your wishes. Follow these steps to fill out the form correctly.

  1. Obtain the North Carolina Do Not Resuscitate Order form. This can be found online or through healthcare providers.
  2. Begin by entering your full name in the designated section at the top of the form.
  3. Provide your date of birth. This helps to clearly identify you as the patient.
  4. Indicate your address, including street, city, state, and zip code.
  5. Next, you will need to select the option that best reflects your wishes regarding resuscitation. This is typically a checkbox or a signature line.
  6. Include the name of your physician or healthcare provider who will be overseeing this order. Their contact information may also be required.
  7. Sign and date the form. Your signature is essential for the form to be valid.
  8. If applicable, have a witness sign the form. This can help ensure that your wishes are upheld.
  9. Make copies of the completed form. Distribute these copies to your healthcare provider, family members, and keep one for your records.

After completing the form, it is essential to discuss your choices with your healthcare provider and family. This ensures that everyone understands your wishes and can act accordingly in an emergency situation.

▼ PDF Form