In modern society, you can make any decisions concerning you and your life. Sometimes these decisions are very difficult but necessary. We are talking about the Do Not Resuscitate (DNR) form.
In Arizona, this form can be used by any citizen who has decided not to use artificial life support if a respiratory arrest or lack of cerebral activity is recorded.
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This DNR form is used if the maintenance of life is impractical; that is, there will be more harm than benefit from resuscitation. Incurable patients decide to stop resuscitation.
Resuscitation can also include:
There are special rules for completing and signing this form. In Arizona, §36-3251 of State Law regulates this. The text provides the wording to be used for this document.
Additionally, it is important to note that the form must be printed on an orange background. The paper size must be in either letter or wallet size.
According to the law, the form must be signed by a:
Moreover, if the patient has appointed an agent to make health care decisions, this agent must sign the form. This refers to the case when the patient can no longer do this due to their condition.
It is possible to cancel the DNR action at any time. To do this, the patient (or the designated agent) must either create a new document or cancel the previous one. But first of all, you need to notify the attending physician about the change in the decision. The doctor will then remove the order from the medical records.
We’ve designed a step-by-step illustrated guide for you to fill out DNR in Arizona.
Filling out the document begins with the provision of personal information about the patient. It is necessary to indicate:
You also need to attach your recent photo, signature, and printed name.
If the patient is in a hospice, it is also necessary to indicate the physician’s name and phone number. Also include the hospice program, if any.
The attending physician or other licensed health care provider must also write their name and sign the document.
The document must be signed in the presence of a witness or a notary public agent.
Note that not every person can be a witness. According to the rules, the witness must be:
The witness also signs and dates the document.