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Homepage ➨ Attorney-Approved Do Not Resuscitate Order Document ➨ Printable Do Not Resuscitate Order Form for the State of Texas
Content Overview

Guide to Writing Texas Do Not Resuscitate Order

Completing the Texas Do Not Resuscitate Order form is an important step in expressing your medical preferences. This document ensures that your wishes regarding resuscitation are clearly understood by healthcare providers. Below are the steps to fill out the form accurately.

  1. Obtain the Texas Do Not Resuscitate Order form. You can find it online or request a copy from your healthcare provider.
  2. Read the instructions carefully to understand the requirements and implications of the form.
  3. Fill in your full name, date of birth, and contact information at the top of the form.
  4. Indicate your preferences regarding resuscitation by checking the appropriate boxes. Make sure to review each option thoroughly.
  5. Sign and date the form in the designated area to validate your choices.
  6. Have your physician sign the form. This step is crucial as it confirms that your doctor has discussed your wishes with you.
  7. Provide copies of the completed form to your healthcare provider, family members, and anyone else who may need to be aware of your preferences.

Once the form is filled out and signed, keep it in a safe but accessible place. It is advisable to inform your loved ones about its location. This ensures that your wishes are respected in a medical emergency.

PDF Form Specs

Fact Name Details
Purpose The Texas Do Not Resuscitate Order (DNR) form allows individuals to refuse resuscitation in the event of cardiac or respiratory arrest.
Governing Law The Texas DNR Order is governed by Chapter 166 of the Texas Health and Safety Code.
Eligibility Any adult can complete a DNR order, including those with terminal conditions or severe chronic illnesses.
Signature Requirement The form must be signed by the individual or their legally authorized representative.
Medical Provider's Role A physician must sign the DNR order to validate it and ensure it is recognized by medical personnel.
Form Availability The Texas DNR form is available through various healthcare providers and can also be downloaded from state health department websites.
Revocation Individuals can revoke their DNR order at any time, and this can be done verbally or in writing.
Emergency Medical Services (EMS) Compliance Emergency medical services are required to honor a valid DNR order as long as it is properly completed and signed.

FAQ

What is a Texas Do Not Resuscitate Order (DNR) form?

A Texas Do Not Resuscitate Order (DNR) form is a legal document that allows a person to refuse cardiopulmonary resuscitation (CPR) and other life-saving measures in the event of a medical emergency. This form is intended for individuals who wish to avoid aggressive medical interventions when their heart stops or they stop breathing.

Who can complete a DNR form in Texas?

The DNR form can be completed by a patient who is at least 18 years old and has the capacity to make medical decisions. If the patient is unable to complete the form, a legally authorized representative, such as a guardian or an agent under a medical power of attorney, may sign on their behalf.

How do I obtain a DNR form?

You can obtain a Texas DNR form from various sources, including:

  • Your healthcare provider or hospital.
  • The Texas Department of State Health Services website.
  • Local health organizations or hospice services.

What information is required on the DNR form?

The DNR form typically requires the following information:

  1. The patient's name and date of birth.
  2. The signature of the patient or their authorized representative.
  3. The date the form was signed.
  4. Contact information for the physician who is aware of the DNR order.

Is a DNR form valid in all healthcare settings?

Yes, a properly completed Texas DNR form is valid in all healthcare settings, including hospitals, nursing homes, and at home. However, it is essential to ensure that the form is easily accessible to healthcare providers when needed.

Can a DNR order be revoked?

Yes, a DNR order can be revoked at any time. The patient or their authorized representative can do this verbally or in writing. It is important to inform healthcare providers of the revocation to ensure that the patient's wishes are respected.

What should I do with the DNR form once it is completed?

Once the DNR form is completed, keep it in a safe but accessible location. It is advisable to provide copies to:

  • Your healthcare provider.
  • Family members or caregivers.
  • Your hospital or medical facility.

Are there any limitations to a DNR order?

Yes, a DNR order specifically applies to resuscitation efforts. It does not affect other medical treatments, such as pain management or comfort care. Patients can still receive appropriate medical care and interventions that align with their overall health goals.

Consider Popular Do Not Resuscitate Order Forms for Specific States

Do Not Resuscitate Form Florida - A DNR may be accompanied by other directives, such as living wills, for comprehensive planning.

When engaging in a transaction involving personal property, it's crucial to utilize the Florida Bill of Sale to confirm ownership transfer. This document acts as essential proof in sales of vehicles, boats, and other significant assets. For those looking to create or learn more about this vital form, resources such as floridadocuments.net/fillable-bill-of-sale-form/ provide useful information to facilitate a seamless process.

How to Get Dnr - A DNRO does not only apply to hospital settings but also to emergency responders in the field.

Dnr Document - Awareness of a patient’s DNR order can help coordinate care amongst all healthcare providers.

Pa Dnr Form - Protects the patient's right to refuse resuscitation and to die naturally when faced with terminal illness.

Texas Do Not Resuscitate Order Example

Texas Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is a legal document under Texas law, allowing the designated individuals to make health care decisions related to resuscitation efforts.

By signing this document, the individual named below is expressing their wish not to undergo cardiopulmonary resuscitation (CPR) and other resuscitative measures in the event of cardiac arrest or respiratory failure.

Patient Information

  • Patient's Full Name: ____________________________________
  • Date of Birth: _________________________________________
  • Address: _____________________________________________

Health Care Provider Information

  • Provider's Name: _______________________________________
  • Provider's Address: ___________________________________
  • Provider's Phone Number: _____________________________

Decision Maker/Surrogate Information

If the patient is unable to make health care decisions, the following person is authorized to act on their behalf:

  • Name: _________________________________________________
  • Relationship to Patient: _______________________________
  • Contact Number: ______________________________________

Authorization

I, the undersigned, hereby declare that I have made an informed decision regarding my health care. I do not wish for resuscitation to be performed in the event of cardiac arrest or respiratory failure.

Patient's Signature: ________________________________________

Date: _________________________________________________

Witness Information

This order must be witnessed by two individuals who are not related by blood or marriage to the patient or the decision-maker.

  1. Witness 1 Name: ____________________________________
  2. Witness 2 Name: ____________________________________

Date Signed: _____________________________________

This Do Not Resuscitate Order is valid in Texas and is in accordance with Texas Health and Safety Code, Chapter 166.