Do Not Resuscitate Form: Where to Get One and How to Complete It

The quickest way to get a Do Not Resuscitate form is to ask your primary care physician, who can provide the correct version for your state and sign it during the same visit. Hospitals, nursing facilities, and hospices are also required to offer the form at admission, and most state health departments publish official versions you can download at no charge. Whichever route you take, a DNR only becomes a legal order once a physician signs it, so learning how to get a Do Not Resuscitate form is really a question of pairing the right document with the right signatures.¹

Before going through the sources, it helps to know what you are actually asking for. A DNR instructs healthcare providers not to perform CPR if your heart stops or you stop breathing. That covers chest compressions, breathing tubes, defibrillation, and resuscitation drugs. It does not touch any other treatment. Pain medication, antibiotics, oxygen, and ordinary care all continue.²

Where To Get the Form

Your Doctor’s Office

This is the simplest path. Your primary care physician can supply the state-approved form, walk you through it, and sign the order at the same appointment. If your doctor has moral objections to writing the order, federal guidance requires that they either transfer your care to a willing provider or work to resolve the disagreement so your wishes are honored.¹

Hospitals, Nursing Homes, and Hospices

Any hospital, skilled nursing facility, or hospice that accepts Medicare or Medicaid must give you written information about your right to create advance directives, including a DNR, when you are admitted. The facility must also document in your medical record whether you already have one.³ If you are already an inpatient and decide you want a DNR, the attending physician can write the order directly into your chart. You do not need to bring a form of your own.

Your State Health Department

Most state health departments publish official DNR forms on their websites, free to download. Search the department’s site for “do not resuscitate” or “out-of-hospital DNR” to find the version paramedics in your state will actually recognize.¹ A blank form downloaded from a state site is not yet an order. It becomes one only after a physician reviews and signs it, and after any patient signatures or witnesses your state requires are added.

In-Hospital or Out-of-Hospital: Pick the Right One

This distinction catches people off guard, and getting it wrong can mean your wishes go unrecognized at the worst possible moment.

An in-hospital DNR is a physician’s order written in your chart while you are a patient in a hospital, nursing home, or similar facility. Staff there follow it because they have direct access to your record. It does not travel with you when you leave.

An out-of-hospital DNR is a separate document designed for use in the community. If paramedics come to your home, they cannot pull up your hospital records. They need a physical form or approved identification they can see immediately. Most states have formal out-of-hospital DNR protocols, and most require a specific state-issued form with a physician’s signature. If you only have an in-hospital DNR and are then discharged home, responders arriving at your house may be legally required to attempt CPR because they have no valid order in front of them.

When you are being discharged, or when you simply want a DNR in effect at home, ask your physician specifically about your state’s out-of-hospital form. Your doctor can also point you toward a wallet card or wearable identification so first responders recognize your status before treatment begins.¹

How To Complete and Activate the Form

Filling in the blanks is only part of the job. Skip a step and you can end up with a document that looks official but carries no legal weight.

Have the conversation first. Talk with your physician about your diagnosis, prognosis, and what CPR realistically offers in your situation. For some conditions the odds of a meaningful recovery are reasonable; for others the process itself can cause serious harm.
Fill out the form completely. Include your full legal name, date of birth, and any specific instructions your state’s form allows.
Get the required signatures. At minimum, the attending physician signs. Most states also require the patient’s signature or that of a legally authorized healthcare agent, and some require two adult witnesses. Check the form itself for its rules.
Enter it in the medical record. Your physician places the signed order in your permanent chart. For out-of-hospital orders, keep the original physical form where it can be found quickly.

The physician’s signature is what turns the paper into an enforceable medical order. Without it, you have a statement of preferences, not a directive providers must follow.⁴

If Someone Else Has To Request It

If you have the mental capacity to make medical decisions, the choice is yours. A competent patient’s refusal of CPR is grounded in the right to self-determination, and no one can override it while you can express your wishes.

If you lack capacity, someone else steps in. The strongest arrangement is a healthcare power of attorney, sometimes called a healthcare proxy, which is a document you sign while competent naming a specific person to make medical decisions for you. If no such document exists and no court-appointed guardian is in place, providers turn to a default surrogate under state law. The typical priority order is:

Spouse or domestic partner
Adult child
Parent
Sibling
Other relatives or, in a growing number of states, a close friend

When several people share the same priority level, most states look for consensus, allow a majority decision, or ask the group to designate one spokesperson. The surrogate’s role is to follow what you would have wanted, not to substitute their own preferences, which is why a written advance directive matters even when a proxy is already named.²

Making Sure Responders Actually Follow It

A DNR no one can find is functionally the same as not having one. Where the document lives, and who knows about it, matters as much as the signatures.

For out-of-hospital orders, keep the original form somewhere visible and expected. Many people tape it to the refrigerator or the inside of the front door, because paramedics are trained to check those spots. Carry a wallet card, and ask your doctor about medical identification jewelry that indicates your DNR status. Some states use standardized bracelets, often purple in clinical settings, though reliability varies by jurisdiction and responding agency.⁵

Distribute copies to everyone involved in your care: your primary doctor, any specialists you see regularly, your healthcare proxy, and close family members. If you move into a new facility, confirm the DNR is transferred into your new medical record. Tell family directly about your decision. When they know in advance, they are far less likely to demand resuscitation in the moment that contradicts your wishes.¹

Changing or Canceling the Order Later

You can cancel a DNR at any time by telling your physician. You do not have to put it in writing, though a follow-up in writing prevents confusion. Your doctor is then required to remove the order from your medical record. If you cannot communicate, your healthcare agent can revoke it for you.

Revocation is not just a chart update. Track down and destroy every physical copy of the form, any wallet cards, and any wearable DNR identification. A paramedic who finds an old bracelet on your wrist has no way of knowing you changed your mind. If you want to adjust the scope of your order rather than cancel it, you generally need to revoke the existing order and create a new one that reflects your updated preferences.

Review the order periodically, especially after a major change in your health, a new diagnosis, or a shift in how you feel about end-of-life care. An outdated DNR can do as much harm as a missing one.²

1
MedlinePlus. Do-not-resuscitate order
2
American Medical Association. AMA Code of Medical Ethics Opinion 5.4 – Orders Not to Attempt Resuscitation
3
Office of the Law Revision Counsel. 42 US Code 1395cc – Agreements With Providers of Services
4
Indian Health Service. Guidelines For Withholding Cardiopulmonary Resuscitation
5
U.S. Food and Drug Administration. Use Purple Bracelets or Wristbands Only for Do Not Resuscitate Status – Letter to Industry