To get a Do Not Resuscitate order, download your state’s official DNR form, complete it with a physician (or, in many states, a nurse practitioner or physician assistant), meet your state’s signature and witness requirements, and keep the signed form somewhere emergency responders will actually see it. A DNR is a medical order telling providers not to perform CPR if your heart or breathing stops. It only takes effect once a physician signs it, and it only helps you if the people responding to an emergency can find it in time.
Where to Get the Right Form
DNR forms are state-specific. Each state sets its own format, required fields, and legal requirements, so a generic template or a form borrowed from another state risks being ignored at the scene. The most reliable source is your state health department’s website, which usually posts the current version as a downloadable PDF.
Your doctor’s office, hospital, or hospice provider can also give you the correct form, and often will as part of an advance care planning conversation. If you are already receiving care in a hospital or nursing home, staff there typically handle the paperwork. For people living at home, the simplest path is asking your primary care provider to start the process.
Who Needs to Sign
Filling out the form is not enough on its own. A DNR becomes enforceable only after it meets your state’s execution requirements.
You sign the form yourself to confirm the request is voluntary and that you understand what it means. If a physical limitation prevents you from signing, most states allow you to direct someone else to sign on your behalf in your presence.
A physician must then sign the order, confirming that CPR was discussed with you and that you gave informed consent. This signature is what transforms the document from a personal wish into a binding medical order. In a growing number of states, nurse practitioners and physician assistants can also sign. The single biggest validity problem in practice is a missing physician signature. Without it, the document is not a medical order and emergency personnel will not follow it.
Many states also require one or two adult witnesses who can confirm you appeared mentally competent and were not being pressured. Witness rules vary. Some states bar anyone who stands to inherit from your estate; others allow family members and even healthcare workers. The restrictions are printed on the form itself, so read them before you gather signatures. A handful of states let you choose between witnesses and a notary, and some require neither. Check the specific state form to see what applies.
If You Cannot Sign for Yourself
If you are already too ill or incapacitated to make medical decisions, a legally authorized representative can consent to a DNR for you. Authority usually comes from one of three sources: a healthcare power of attorney you signed while you still had capacity, a court guardianship order, or a state surrogate consent law that designates family members in a set priority, usually spouse, then adult children, then parents, then siblings.
The representative signs in the designated section of the form, and the physician still co-signs after confirming the decision matches your known wishes or best interests. One point worth understanding: if you already had a valid DNR in place before losing capacity, your family generally cannot override or revoke it. The order reflects your own decision and stands unless you personally revoke it.
In-Hospital vs. Out-of-Hospital DNR
There are two versions of the order, and picking the right one matters. An in-hospital DNR is written by your physician and placed directly into your medical chart. If your heart or breathing stops while you are admitted, hospital staff sees the order and follows it. You do not need to carry paperwork because the order lives in the record.
An out-of-hospital DNR, sometimes called a prehospital DNR, is designed for situations outside a hospital: at home, in assisted living, in a nursing home, or anywhere EMS might respond. This version requires a physical form or wearable identification, because paramedics have no access to your hospital chart. Without something visible at the scene, EMS crews are trained to begin CPR by default. If you spend most of your time outside a hospital, the out-of-hospital DNR is the one that matters, and it is the one to focus on.
Making Sure Responders Can Find It
A valid DNR that nobody can find is effectively useless. Emergency responders have seconds to decide whether an order is in place, and their default is to resuscitate.
- At home, tape or magnet the original form to your refrigerator or the wall next to your front door. EMS crews are trained to check the refrigerator area for medical documents.
- Give copies to your primary care physician, any specialists you see regularly, and the local hospital where you would most likely be taken in an emergency. Each facility should add the DNR to your medical record.
- Carry a DNR wallet card or wear a medical alert bracelet or necklace. Several states recognize specific DNR identification devices, and when responders see an intact identifier, they provide comfort care rather than attempting resuscitation.
- Give a copy to your healthcare agent and make sure they know where the original is kept. In a crisis they may need to present it to hospital staff who have never treated you.
- If your state maintains a DNR registry that emergency responders can access electronically, enrolling adds another layer of assurance that your wishes will be found even when the physical form is not.
Changing Your Mind
A DNR is never permanent. You can cancel it at any time, for any reason, without explaining why. Revocation can be as simple as telling your doctor or any healthcare provider that you no longer want the order in place. You can also revoke it by destroying the physical form, removing any DNR identification you wear, or having your healthcare agent communicate the revocation if you cannot do so yourself. Once revoked, your medical team updates your chart and resumes standard resuscitation protocols. If you change your mind again later, you can complete a new form.
If You Travel or Move to Another State
Interstate recognition of DNR orders is inconsistent. No federal law requires one state to honor another state’s form, and each state’s EMS protocols are built around its own specific document. A DNR signed in one state may not be followed by paramedics in another, particularly if the form looks unfamiliar or does not match the local format.
If you are moving permanently, complete a new DNR in your new state with a provider licensed there. If you split time between two states, keep a valid form on file in each one. For shorter trips, carrying your existing DNR and any supporting advance directive documentation is better than nothing, but an out-of-state form is not guaranteed to be honored at the scene.
What a DNR Does Not Cover
A DNR addresses one decision: whether providers should attempt CPR if your heart or breathing stops. It does not affect other treatments such as pain medication, antibiotics, or nutrition, and it does not decide questions about mechanical ventilation, feeding tubes, hospital transfers, or your broader goals of care. Those decisions belong in a living will or a POLST-style form (called MOLST, COLST, POST, or MOST in some states), which can sit alongside your DNR. If your wishes go beyond CPR alone, ask your provider whether your state’s POLST-equivalent form is the better fit or whether you need both documents.