Blank Do Not Resuscitate Order Template for Florida

A Do Not Resuscitate Order is a legal document that allows a person to refuse resuscitation in the event of a medical emergency. In Florida, this order specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) or other life-saving measures if the individual’s heart stops or they stop breathing. It is designed for individuals who have a terminal illness or a condition that significantly diminishes their quality of life.

In Florida, a DNR Order can be requested by any adult who is capable of making their own healthcare decisions. This includes individuals who are of sound mind and understand the implications of the order. Additionally, a legally authorized representative, such as a healthcare surrogate or power of attorney, may also request a DNR Order on behalf of an individual who is unable to do so.

To obtain a DNR Order, an individual must complete the Florida Department of Health's official DNR Order form. This form must be signed by the patient and a physician. It is important to ensure that the physician understands the patient's wishes regarding end-of-life care. Once the form is completed, it should be kept in a prominent place, such as with other important medical documents or on the refrigerator, so that it can be easily accessed by emergency responders.

No, a DNR Order specifically pertains to resuscitation efforts. It does not prevent individuals from receiving other medical treatments or interventions. Patients can still receive pain management, comfort care, and any other medical care that is deemed necessary. It is crucial for patients to communicate their overall healthcare wishes with their healthcare providers to ensure that their preferences are respected.

Yes, a DNR Order can be revoked at any time. The individual who signed the order, or their authorized representative, can verbally express their wish to revoke it or can complete a new DNR Order form. It is advisable to inform healthcare providers of any changes to ensure that the most current wishes are followed. Keeping a record of the revocation can also help avoid confusion in emergency situations.

Incomplete Information: Failing to fill out all required fields can lead to confusion. Ensure that all personal details are accurate and complete.

Not Signing the Form: The form must be signed by the patient or their legal representative. Omitting this step renders the document invalid.

Incorrect Witness Signatures: The form requires two witnesses. If the witnesses are not eligible or do not sign, the order may not be honored.

Using Outdated Forms: Always use the most current version of the Do Not Resuscitate Order form. Older versions may not be recognized by healthcare providers.

Not Discussing with Healthcare Providers: It is crucial to have conversations with doctors or healthcare teams about the implications of the order. Lack of communication can lead to misunderstandings.

Ignoring State-Specific Requirements: Each state may have specific rules regarding DNR orders. Familiarize yourself with Florida's requirements to ensure compliance.

Failing to Keep Copies: After completing the form, make copies for personal records and for your healthcare providers. Not having copies can complicate enforcement of the order.

Not Reviewing Regularly: Life circumstances change. Regularly reviewing and updating the DNR order ensures it reflects current wishes.

Assuming Family Members Understand: Family members may not be aware of the DNR order or its implications. Discuss your wishes with them to avoid confusion during critical times.