New Jersey Do Not Resuscitate Order (DNR) Form

The New Jersey do not resuscitate form (or DNR form) is a legal document issued at the patient’s request by their physician after consultation with the latter, in cases when the patient does not want to be rescued during a severe medical condition such as heart attack. Usually, patients ask for this form in cases when their medical condition is terminal, and any attempts to resuscitate would only prolong suffering. Also, it is important to mention that a signed DNR form can be revoked at any time by the patient or the person who signed it on behalf of the patient.

The most important issue with DNR forms in New Jersey and the US, in general, is that doctors should fill out the printable DNR form very carefully because otherwise, there would be some serious legal problems.

You can find all legal requirements related to the DNR forms in New Jersey in rule N.J.A.C. 10:48B of the New Jersey Administrative Code.

The Administrative code describes three situations when a DNR form can be signed:

  • The patient’s permanent state of unconsciousness
  • The medical conditions of the patient are terminal
  • Medical expertise shows that any resuscitate operation could worsen the condition of the patient

Also, the law of New Jersey permits the DNR form to be signed by a person acting on behalf of the patient if the patient is unconscious or if their mental conditions hinder the patient from making such medical decisions.

The DNR form in New Jersey should be signed by the patient (or person acting on their behalf) and the physician.

Template Preview
Download your fillable New Jersey DNR form in PDF format.

How to fill out New Jersey DNR form

Filling out the New Jersey DNR form is not a complicated process; it can be done by a person without any knowledge of the law. To make everything right, make sure to follow our guide.

  • So, the first step in filling out the DNR form is to write the name and surname of the patient. You have to write it in the blank space in the first paragraph on top of the paper.

step 1 to filling out the new jersey dnr form

  • Now you have to append the patient’s signature in a special blank space, and before the signing, you have to write the patient’s address.

step 2 to filling out the new jersey dnr form

  • Here you have to provide all the necessary information of the attending physician, such as name, the medical establishment, telephone number, address. The physician has to sign the document in a special space below the information mentioned above. Also, the date of signing of the document should be written to the right from the signature.

step 3 to filling out the new jersey dnr form

  • At the end of the document, you have to provide the data on the patient’s contact person—their name, surname, and contact number.

step 4 to filling out the new jersey dnr form

Published: Oct 18, 2021