To get a Do Not Resuscitate order, ask your doctor to write one after a conversation about your end-of-life wishes. A DNR is a medical order, not a legal document you draft with a lawyer, so the process runs through your healthcare provider. You complete your state’s official form, get it signed by a qualified provider (and usually witnesses), and distribute copies to everyone involved in your care. One detail catches most people off guard: if you want the order honored at home, you almost certainly need a separate out-of-hospital DNR form that emergency responders will recognize.
Talk With Your Doctor First
Raising the topic with your doctor is less awkward than most people expect. Physicians have these conversations regularly, and it is far easier for a medical team to follow clear instructions you discussed in advance than to guess your wishes during a crisis. You do not need a terminal diagnosis. Many people complete DNR orders during routine appointments, especially as they age.
Any adult who can understand the decision and communicate a choice is eligible. Your doctor does not need to determine that you are terminally ill or that resuscitation would be futile. A physician will confirm your decision-making capacity, which means checking that you understand what CPR involves, what refusing it means, and that you can express a clear preference. Making a choice others disagree with does not indicate a lack of capacity.
Come prepared to discuss what quality of life means to you and where you would draw the line on medical intervention. Useful questions to raise:
- What CPR realistically looks like for someone with your health profile, since success rates vary with age and underlying conditions.
- What treatments you would still receive with a DNR in place. A DNR only refuses chest compressions, defibrillation, intubation, mechanical ventilation, and resuscitative drugs. Pain management, antibiotics, IV fluids, oxygen for comfort, and treatment for other conditions all continue.
- Whether your state uses a standalone DNR form, a POLST-style form, or both.
If you are being admitted to a hospital, skilled nursing facility, hospice, or home health agency that accepts Medicare, the facility is required to inform you of your right to make advance care decisions and to ask whether you already have an advance directive.1Office of the Law Revision Counsel. 42 U.S. Code 1395cc – Agreements With Providers of Services They cannot condition your care on whether you sign one.
Use Your State’s Official DNR Form
Once you and your doctor agree on a DNR, the next step is paperwork. Your doctor’s office, the hospital, or your state’s health department website will have the official form. Use only the form your state recognizes. A generic document, a form from another state, or a printout from an unofficial source may not be honored, especially by emergency responders.
There is typically no fee for the form itself. You may pay a small charge if the form needs notarization; notary fees are capped by state law and usually run between $2 and $15 per signature.
Get the Right Signatures
At a minimum, the form requires your signature and your provider’s signature. In many states the provider must be a physician (MD or DO), but a growing number of states also authorize nurse practitioners and physician assistants to sign DNR and POLST orders.2MedlinePlus. Do-Not-Resuscitate Order A form signed by an unauthorized provider may be treated as invalid, so check what your state accepts.
Many states also require two adult witnesses to watch you sign and add their own signatures. Witnesses generally cannot be people involved in your medical care or anyone with a financial interest in your estate. In some states, a notary public can substitute for witnesses. These requirements exist to confirm you signed voluntarily and with capacity. Skip a required witness or notary and the form may not be enforceable.
Get a Separate Out-of-Hospital DNR if You Want EMS to Honor It
This is the gap that trips up most people. A standard DNR sitting in your hospital chart may not protect you at home. Most states maintain separate out-of-hospital DNR programs with their own specific forms, and emergency responders are trained to look for those forms rather than hospital paperwork. Over 40 states had established statewide out-of-hospital DNR protocols by the early 2000s, and that number has continued to grow.3American College of Emergency Physicians. “Do Not Attempt Resuscitation” Orders in the Out-of-Hospital Setting
When paramedics respond to a 911 call, they follow protocols that require a properly completed out-of-hospital DNR form or an approved DNR identification device. A living will, a healthcare power of attorney, or even a hospital-issued DNR generally will not stop EMS from beginning CPR. If no valid out-of-hospital form is present, most protocols require paramedics to begin resuscitation and contact their medical director for guidance.
Ask your doctor specifically about your state’s out-of-hospital DNR form. It may go by a different name. Some states call it a Comfort Care form; others use their POLST program to cover out-of-hospital scenarios. Whatever the name, make sure you have the right document for the setting where you spend most of your time.
Consider a POLST if You Want Broader Coverage
A Physician Order for Life-Sustaining Treatment (POLST) covers more ground than a standalone DNR. A DNR addresses only resuscitation. A POLST lets you specify preferences on mechanical ventilation, feeding tubes, antibiotics, hospitalization, and other interventions during a medical emergency. Programs go by different names depending on the state, including MOLST, POST, and MOST, but they serve the same function. Nearly every state now has an active or developing POLST program.
Like a DNR, a POLST is a medical order signed by a healthcare provider, which means it carries binding authority a living will alone does not. If you have a serious progressive illness or advanced frailty, a POLST may give you a single document that handles both your DNR preference and your broader treatment wishes.
Distribute Copies and Make the Form Findable
A DNR that nobody can find during an emergency is functionally useless. Getting the paperwork right is only half the job.
Give Copies to Your Providers
Give copies to your primary care doctor, any specialists you see regularly, and any hospital or facility where you receive care. Each provider should place the DNR in your medical record. If you have a healthcare agent, make sure they have a copy and know where the original is stored.
Keep It Visible at Home
For out-of-hospital DNR orders, keep the form somewhere paramedics can find it fast. The refrigerator door is the most common recommendation, and many EMS protocols specifically instruct paramedics to check there. Do not file it away in a drawer or safe. If responders cannot find it quickly, they will begin CPR.
Look Into DNR Identification
Some states authorize medical alert bracelets, necklaces, or wallet cards as valid DNR identification that EMS will recognize. The rules are highly state-specific. Some states issue official bracelets through their health department; others accept commercially available medical alert jewelry only if it meets certain criteria, such as displaying your full name and the words “Do Not Resuscitate.” A generic medical ID bracelet you bought online may not meet your state’s requirements. Check with your doctor or state health department before relying on jewelry alone.
Tell Your Family
Inform your family and close contacts about your DNR. A family member who does not know about it may instruct paramedics to “do everything,” creating confusion and delay. A family member who does know can direct responders to the form if you cannot speak for yourself.
If Someone Else Is Requesting a DNR on Your Behalf
If a person has lost the ability to make medical decisions, someone else can request a DNR for them. The strongest option is a person previously designated as healthcare agent through a power of attorney for health care. That person has legal authority to consent to or refuse treatment, including resuscitation, once a physician confirms the patient can no longer decide.
Without a named agent, most states assign a default surrogate using a priority list that typically runs: spouse or domestic partner, adult child, parent, sibling, other close relatives. A growing number of states also allow a close friend to serve. The exact hierarchy varies, and family disagreements sometimes require a hospital ethics committee or a court to resolve. Naming a healthcare agent in writing while you are able removes that ambiguity.
Changing Your Mind Later
A DNR is not permanent. You can revoke it at any time, for any reason, as long as you still have decision-making capacity. The simplest method is to tell your doctor or any medical professional directly that you want resuscitation. Verbal revocation is effective in most states and takes effect immediately. You can also revoke in writing by signing a cancellation document or physically destroying the existing form.
After revoking, make sure your doctor removes the DNR from your medical record and notifies other providers who have copies. If you have been wearing a DNR bracelet or carrying a wallet card, remove or destroy it. A stale DNR floating around a medical record or pinned to a refrigerator after you have changed your mind could lead to exactly the outcome you no longer want.
If a healthcare agent previously consented to a DNR on your behalf and you regain capacity, you can override that decision yourself. Your own wishes, expressed while competent, take priority over a surrogate’s prior consent.