Free Do Not Resuscitate Order Template for the State of Ohio
Form Breakdown
| Fact Name | Details |
|---|---|
| Definition | The Ohio Do Not Resuscitate (DNR) Order form allows individuals to refuse resuscitation efforts in case of cardiac arrest or respiratory failure. |
| Governing Law | The DNR Order in Ohio is governed by Ohio Revised Code Section 2133.21 to 2133.27. |
| Eligibility | Any adult or emancipated minor can complete a DNR Order, provided they have the capacity to make medical decisions. |
| Signature Requirements | The form must be signed by the patient and a physician. It can also be signed by a legal representative if the patient is unable to do so. |
| Implementation | Healthcare providers must honor the DNR Order as long as it is properly completed and signed, ensuring the patient's wishes are respected. |
Sample - Ohio Do Not Resuscitate Order Form
Ohio Do Not Resuscitate Order Template
This Do Not Resuscitate (DNR) Order is in accordance with Ohio Revised Code § 2133.21. It reflects the wishes of the individual regarding resuscitative measures. Please fill in the blanks with the appropriate information.
Patient Information:
- Name: __________________________
- Date of Birth: __________________________
- Medical Record Number: __________________________
Patient's Declaration:
I, the undersigned, am of sound mind and wish to establish this Do Not Resuscitate Order. I do not wish to receive cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) in the event of cardiac or respiratory arrest.
Signature: __________________________
Date: __________________________
Witness Information:
- Witness Name: __________________________
- Witness Signature: __________________________
- Date: __________________________
This DNR Order should be kept in a prominent location and provided to emergency personnel as necessary. It may also be advisable to discuss this decision with healthcare providers and family members.
Common mistakes
When completing the Ohio Do Not Resuscitate Order form, individuals often overlook critical details that can lead to confusion or invalidation of the document. One common mistake is failing to provide the necessary signatures. The form requires signatures from both the patient and the physician. Without these, the order may not be honored by medical personnel during emergencies.
Another frequent error involves not clearly indicating the patient's wishes. It is essential to fill out the form accurately, specifying whether the patient desires to forgo resuscitation efforts. Ambiguous language or incomplete sections can create uncertainty for healthcare providers. This lack of clarity might result in unwanted interventions, contrary to the patient’s intentions.
Additionally, individuals sometimes neglect to review the form after completion. Changes in health status or treatment preferences can occur over time. If the form is not updated to reflect the current wishes of the patient, it may no longer serve its intended purpose. Regularly revisiting and revising the document ensures that it aligns with the patient’s current healthcare goals.
Lastly, people often fail to distribute copies of the completed form to relevant parties. Simply filling out the form does not guarantee that medical staff will be aware of it during a critical moment. It is vital to share copies with healthcare providers, family members, and anyone involved in the patient’s care. This proactive approach helps ensure that the patient's wishes are respected in times of need.
Discover More Do Not Resuscitate Order Templates for Specific States
Do Not Resuscitate Michigan - Educational materials about the Do Not Resuscitate order can assist individuals in making informed choices.
Dnr Definition - Many states allow individuals to register their DNR wishes through a digital registry or database.
Dnr Directive - Legally, a DNR form must be signed and dated by a physician to be recognized.
To simplify the process of transferring ownership, you can find the necessary Trailer Bill of Sale form at PDF Documents Hub, which provides a convenient way to document this important transaction while ensuring all legal requirements are met.
Do Not Resuscitate Form Georgia - Patients should periodically review their DNR orders to ensure it reflects their current wishes.