Official Do Not Resuscitate Order Template for the State of Florida

• Living Will: A living will outlines a person's wishes regarding medical treatment in situations where they are unable to communicate. Like a DNR order, it provides guidance on end-of-life care preferences.
• Healthcare Power of Attorney: This document designates someone to make healthcare decisions on behalf of an individual. Similar to a DNR, it ensures that a person's medical wishes are respected when they cannot speak for themselves.
• Do Not Intubate (DNI) Order: A DNI order specifically states that a patient should not be placed on a ventilator. It complements a DNR order by addressing another aspect of life-sustaining treatment.
• Physician Orders for Life-Sustaining Treatment (POLST): This document translates a patient's wishes into actionable medical orders. It is similar to a DNR in that it guides healthcare providers in emergency situations.
• Advance Directive: An advance directive is a broader term that includes both living wills and healthcare powers of attorney. It serves to communicate an individual’s preferences regarding medical care, including resuscitation efforts.
• Lease Agreement: The Ohio Lease Agreement form outlines essential terms for renting residential property and can be accessed through Fillable Forms.
• Patient Advocate Designation: This document allows an individual to appoint someone to advocate for their healthcare preferences. Like a DNR, it ensures that personal wishes are honored during medical emergencies.
• Do Not Hospitalize (DNH) Order: A DNH order specifies that a patient should not be admitted to a hospital for treatment. It aligns with the principles of a DNR by focusing on the patient's comfort and preferences in critical situations.
• Comfort Care Order: This document emphasizes providing comfort rather than curative treatment in end-of-life situations. It is similar to a DNR in that both prioritize quality of life over aggressive medical interventions.

Filling out and using the Florida Do Not Resuscitate Order (DNRO) form is an important decision for individuals and their families. Here are some key takeaways to consider:

• The DNRO form must be completed and signed by a physician. This ensures that the order is valid and recognized by medical personnel.
• It is essential to discuss your wishes with family members and caregivers. Open communication helps everyone understand your preferences regarding resuscitation.
• The DNRO form should be easily accessible. Keep a copy in a visible place, such as on the refrigerator or with medical records, so that it can be quickly located in an emergency.
• Review the DNRO regularly. Your health status and preferences may change over time, so it is important to update the form as needed.

Instructions on How to Fill Out Florida Do Not Resuscitate Order

After obtaining the Florida Do Not Resuscitate Order form, it is important to fill it out accurately to ensure that your wishes are clearly communicated. Follow these steps carefully to complete the form.

1. Start by writing the patient's full name at the top of the form.
2. Provide the patient's date of birth to confirm their identity.
3. Indicate the patient's address, including the city, state, and zip code.
4. Fill in the name of the patient's physician. This should be a licensed medical doctor who is familiar with the patient's health status.
5. Include the physician's contact information, such as their phone number and address.
6. Clearly state the patient's wishes regarding resuscitation in the designated section. This typically involves checking a box or signing a statement.
7. Have the patient or their legal representative sign and date the form. If the patient is unable to sign, a legal representative must do so.
8. Ensure that the form is witnessed by two adults who are not related to the patient and do not stand to gain from the patient's estate.
9. Keep a copy of the completed form for personal records and provide copies to the patient's healthcare providers.