Online Form Templates

Online Form Templates

Homepage Attorney-Approved Do Not Resuscitate Order Template Valid Do Not Resuscitate Order Form for Texas
Table of Contents

In Texas, the Do Not Resuscitate (DNR) Order form plays a crucial role in ensuring that individuals receive the medical care they desire at the end of life. This form is designed for patients who wish to decline resuscitation efforts in the event of a cardiac or respiratory arrest. It reflects a person's wishes regarding life-sustaining treatments, allowing them to maintain control over their medical decisions. The DNR order must be completed and signed by a physician, and it typically includes the patient's name, date of birth, and specific instructions regarding resuscitation. Importantly, the form should be readily accessible, often kept in a visible location, such as on the refrigerator or with other important documents, to ensure that emergency medical personnel can easily find it. Understanding the implications of this order is essential for patients, families, and healthcare providers alike, as it fosters conversations about end-of-life preferences and aligns medical interventions with the patient's values and desires.

Common mistakes

  1. Not Understanding the Purpose: Many individuals fill out the Texas Do Not Resuscitate Order (DNR) form without fully grasping its purpose. A DNR order is a legal document that instructs medical personnel not to perform CPR if the heart stops or if breathing ceases. It's crucial to understand that this does not affect other medical treatments.

  2. Incorrect Completion: Some people fail to complete the form correctly. This can include missing signatures or not providing necessary information. Each section must be filled out accurately to ensure the document is valid and reflects the individual's wishes.

  3. Not Discussing with Family: A common mistake is not discussing the DNR decision with family members or loved ones. Open conversations can prevent confusion and ensure that everyone understands the individual's wishes. It’s essential to have support and clarity among family members regarding such a significant decision.

  4. Forgetting to Update: Life circumstances change, and so might one’s wishes regarding resuscitation. People often forget to revisit and update their DNR orders as needed. Regularly reviewing this document ensures that it aligns with current healthcare preferences and personal values.

  5. Not Keeping Copies Accessible: After filling out the form, individuals sometimes neglect to keep copies in accessible places. It’s important to provide copies to healthcare providers, family members, and keep one in a visible location at home. This ensures that the DNR order can be easily located when needed.

Example - Texas Do Not Resuscitate Order Form

Texas Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is established in accordance with Texas Health and Safety Code, Chapter 166. It allows individuals to direct that resuscitation measures not be performed in the event of cardiac or respiratory arrest.

Please complete the following information:

  • Patient's Name: ________________________________________
  • Date of Birth: ________________________________________
  • Patient's Address: _____________________________________
  • City: ______________________ State: TX Zip Code: ___________
  • Primary Physician's Name: _______________________________
  • Primary Physician's Phone Number: ______________________

This order should be honored by all medical personnel. In case of an emergency, medical staff must review this document.

  1. Signature of Patient or Legal Guardian: ___________________________
  2. Date: ___________________________

If this order was signed by a legal guardian, please complete:

  • Legal Guardian's Name: ___________________________________
  • Relationship to Patient: _________________________________

It is essential to keep this document accessible and to discuss your wishes with your family and healthcare providers to ensure they understand your directives.

More About Texas Do Not Resuscitate Order

What is a Texas Do Not Resuscitate Order (DNR) form?

A Texas Do Not Resuscitate Order (DNR) form is a legal document that allows a person to refuse resuscitation in the event of a medical emergency. This means that if the person’s heart stops or they stop breathing, medical personnel will not perform CPR or other life-saving measures. The DNR form must be signed by a physician and the patient or their legal representative to be valid.

Who can request a DNR order in Texas?

In Texas, a DNR order can be requested by any adult who is capable of making their own medical decisions. If the person is unable to make decisions, a legally authorized representative, such as a family member or guardian, can request the order on their behalf. It’s important that the individual understands the implications of a DNR order before signing.

How do I obtain a DNR form in Texas?

You can obtain a Texas DNR form from various sources. Hospitals and healthcare providers typically have these forms available. Additionally, the Texas Department of State Health Services provides downloadable forms on their website. Make sure to fill out the form completely and have it signed by a physician to ensure it is valid.

What should I do with the DNR form once it is completed?

Once the DNR form is completed and signed, it is crucial to keep it in an easily accessible location. You should provide copies to your healthcare providers, family members, and anyone else involved in your care. Consider keeping a copy in your medical records and having it available at your home. This ensures that your wishes are known and respected in an emergency situation.

Key takeaways

Filling out a Texas Do Not Resuscitate (DNR) Order form is an important decision for individuals and their families. Here are key takeaways to consider:

  • The DNR Order is a legal document that indicates a person's wish not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  • It is essential to discuss the decision with healthcare providers, family members, and legal representatives to ensure everyone understands the implications.
  • The form must be completed and signed by a physician who is familiar with the patient's medical condition.
  • The patient, or their legally authorized representative, must also sign the DNR Order to make it valid.
  • Once completed, the DNR Order should be kept in an accessible location, such as a medical file or a visible area in the home.
  • It is advisable to provide copies of the DNR Order to all healthcare providers involved in the patient's care.
  • Patients can revoke or modify the DNR Order at any time, provided they communicate their wishes clearly to their healthcare team.
  • Healthcare providers are legally required to honor a valid DNR Order, ensuring that the patient's wishes are respected during medical emergencies.

File Details

Fact Name Description
Definition A Texas Do Not Resuscitate (DNR) Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
Governing Law The Texas DNR Order is governed by Texas Health and Safety Code, Chapter 166.
Eligibility Any adult can create a DNR order, provided they are capable of making informed decisions about their medical care.
Signature Requirement The DNR order must be signed by the patient or their legally authorized representative.
Medical Provider's Role Healthcare providers are required to honor a valid DNR order, ensuring that the patient's wishes are respected.
Form Availability The Texas DNR order form is available through various healthcare facilities and can also be downloaded online.
Revocation A DNR order can be revoked at any time by the patient or their representative, either verbally or in writing.
Emergency Medical Services Emergency medical personnel must be informed of the DNR order to ensure it is followed during emergencies.
Placement It is advisable to keep the DNR order in a visible location, such as on the refrigerator or with the patient's medical records.
Related Documents Patients may also consider creating an advance directive, which outlines their broader healthcare preferences beyond just resuscitation.

Dos and Don'ts

When filling out the Texas Do Not Resuscitate Order form, it is important to follow certain guidelines to ensure that your wishes are respected. Here are six things you should and shouldn't do:

  • Do discuss your wishes with your healthcare provider before completing the form.
  • Do ensure that the form is signed by you or your legal representative.
  • Do keep a copy of the completed form in a safe place and share it with your family.
  • Don't fill out the form if you are not fully informed about its implications.
  • Don't forget to update the form if your wishes change.
  • Don't assume that verbal instructions will be enough; always use the official form.