Out of Hospital DNR Frequently Asked Questions
This document provides essential information regarding the Out of Hospital Do Not Resuscitate (OHDNR) forms, including their validity and instructions for use. It addresses common questions and offers clarity on who can sign the forms and how to fill them out properly. Users will find practical guidance for managing their DNR wishes effectively.
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How do I fill this out?
Filling out the Out of Hospital Do Not Resuscitate (OHDNR) form involves understanding the requirements and properly completing the necessary sections. It is crucial to ensure that the form is signed by the patient or their designated representative. Follow the instructions provided on the reverse side of the form to ensure compliance with legal standards.

How to fill out the Out of Hospital DNR Frequently Asked Questions?
1
Obtain the OHDNR form either online or from a healthcare provider.
2
Read the instructions carefully before filling out the form.
3
Complete the required fields accurately and completely.
4
Ensure the form is signed by the patient or their representative.
5
Keep the completed form in an accessible location for emergency personnel.
Who needs the Out of Hospital DNR Frequently Asked Questions?
1
Individuals aged 18 or older who want to set their DNR wishes.
2
Patients with terminal illnesses who wish to avoid invasive procedures.
3
Family members of incapacitated individuals who need to express DNR orders.
4
Healthcare proxies designated to make decisions on behalf of a patient.
5
Caregivers or health professionals needing guidance on DNR orders.
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What are the instructions for submitting this form?
To submit the completed OHDNR form, please send it to your local healthcare provider. This can be done via email, fax, or in person at their office. For electronic submissions, verify the receiving email address or fax number to ensure it reaches the appropriate department. It's advisable to keep a copy for your records.
What are the important dates for this form in 2024 and 2025?
The OHDNR form does not have fixed important dates as it remains valid indefinitely once signed. However, it's a good practice to review your DNR status annually or whenever your medical condition changes significantly. Make sure to communicate your DNR wishes with your healthcare provider regularly.

What is the purpose of this form?
The purpose of the OHDNR form is to express an individual's wishes regarding resuscitation efforts in an out-of-hospital setting. This form ensures that patients receive care aligned with their preferences during emergencies when they cannot communicate. By using this form, individuals can avoid unwanted medical interventions that may not align with their values or desires.

Tell me about this form and its components and fields line-by-line.

- 1. Patient Information: Includes the patient's name, date of birth, and contact information.
- 2. Patient Representative: Details about the patient representative if applicable.
- 3. Signature: Area for the patient or representative to sign the document.
- 4. Date: Space to indicate the date the form is completed.
What happens if I fail to submit this form?
Failure to submit the OHDNR form may lead to unwanted resuscitative interventions in a medical emergency. Without this form, healthcare providers might not be aware of the patient's preferences regarding resuscitation. It's crucial to ensure that the form is completed and available to avoid confusion during critical situations.
- Unwanted Medical Interventions: Patients may receive resuscitation efforts that they do not want.
- Conflicting Wishes: Family members may have different views on resuscitation preferences.
- Legal Implications: Healthcare providers may face legal issues if a patient's wishes are not documented.
How do I know when to use this form?

- 1. During Medical Emergencies: To inform ambulance staff and first responders of your resuscitation preferences.
- 2. In End-of-Life Care Planning: As part of your advanced healthcare directives.
- 3. For Caregivers: To provide guidance to caregivers about the patient's wishes.
Frequently Asked Questions
Is my existing DNR form now illegal?
No, any existing DNR form is still valid and carries the same protections.
Can the next of kin act as a surrogate and sign the new purple OHDNR form?
No, only the patient or designated patient representative may sign the form.
What is a patient representative?
A patient representative can be an attorney in fact or a guardian responsible for the patient.
Are there instructions that will tell me how to complete the form?
Yes, the instructions are on the reverse side of the form.
Is there a specific color of purple designated?
No, any shade of purple paper is acceptable.
Can my OHDNR form be used while I am in the hospital?
No, the form is intended for use outside the hospital.
What happens if my form is not signed?
The form will not be valid until signed by the appropriate individual.
Can I use a photocopy of the form?
Yes, photocopies or faxes of the OHDNR form are acceptable.
Who can I contact if I have questions about OHDNR?
Contact your local ambulance service or the Bureau of EMS at (573)751-6356.
When should I complete the OHDNR form?
If you want to ensure your resuscitation preferences are respected outside the hospital.
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