Get Your Do Not Resuscitate Order Now

Legal Do Not Resuscitate Order Template for Texas State

A Texas Do Not Resuscitate Order (DNR) form is a legal document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. This form ensures that healthcare providers respect a person's decision not to receive life-saving treatments, such as CPR, in specific situations. Understanding how to properly complete and utilize this form is essential for anyone considering end-of-life care options.

Get Your Do Not Resuscitate Order Now

Article Guide

Other Common Do Not Resuscitate Order State Templates

How Do I Get a Dnr - The form can be used in conjunction with palliative care options for holistic end-of-life management.

Dnr Paperwork - It allows patients to express their personal wishes regarding end-of-life care in a clear manner.

Utilizing an accurate Employment Verification process can significantly streamline communication between employers and employees, ensuring that proper verification of employment details is conducted efficiently and effectively in compliance with necessary regulations.

Dnr and Dni Documents Are All Part of What Are Known as - Experiencing advanced illness often prompts discussions regarding DNR orders for patients and families.

➤ PDF File

Example - Texas Do Not Resuscitate Order Form

Texas Do Not Resuscitate Order

This document serves as a Texas Do Not Resuscitate (DNR) Order, in accordance with the Texas Health and Safety Code, Chapter 166. It allows individuals to specify their wishes regarding resuscitation efforts in the event of a medical emergency.

Patient Information:

Full Name: __________________________
Date of Birth: ______________________
Address: ____________________________
City: ______________________________
State: Texas
Zip Code: ________________________

Declaration of Do Not Resuscitate Order:

I, the undersigned, hereby declare that I do not wish to receive cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest. This order shall remain effective until revoked in writing.

Patient Signature: _________________________

Date: _____________________

Healthcare Proxy Information:

Name: __________________________
Phone Number: __________________
Relationship to Patient: ___________

Witness Information:

Witness Name: ________________________
Witness Signature: _____________________
Date: __________________________

This DNR Order should be placed in the patient’s medical record and readily available to medical personnel. It is recommended to discuss the contents of this order with both family members and healthcare providers to ensure clarity and understanding.

Documents used along the form

When considering end-of-life care, it's essential to have a comprehensive understanding of various legal documents that can work in tandem with the Texas Do Not Resuscitate (DNR) Order. These forms help ensure that your medical wishes are honored and provide clarity for healthcare providers and loved ones. Below is a list of important documents that are often used alongside the DNR Order in Texas.

Advance Directive: This document outlines your preferences for medical treatment in situations where you may be unable to communicate your wishes. It can include instructions about life-sustaining treatments, organ donation, and other critical decisions.
Medical Power of Attorney: This form designates a trusted individual to make healthcare decisions on your behalf if you become incapacitated. It is crucial for ensuring that someone who understands your values and preferences can advocate for you.
Living Will: A living will is a type of advance directive that specifically addresses your wishes regarding life-sustaining treatment. It provides clear guidance on your preferences for care in terminal or irreversible conditions.
Physician Orders for Life-Sustaining Treatment (POLST): This document translates your treatment preferences into medical orders. It is intended for individuals with serious illnesses and ensures that your wishes are respected across different healthcare settings.
Do Not Intubate (DNI) Order: Similar to a DNR, this order specifies that you do not wish to be placed on a ventilator or receive intubation if you are unable to breathe on your own. It is an important component of end-of-life care planning.
Florida Do Not Resuscitate Order: This legal document provides a clear directive regarding a person's wishes for resuscitation, similar to the Texas equivalent. For more information, you can refer to Florida PDF Forms.
Funeral Planning Documents: These documents outline your preferences for funeral arrangements, including burial or cremation. Having these details in writing can relieve your family of decision-making burdens during a difficult time.
Organ Donation Consent: If you wish to donate your organs after death, this document indicates your consent. It can be included in your advance directive or as a separate form, ensuring your wishes are known and respected.

Understanding these documents can empower you to make informed decisions about your healthcare and end-of-life preferences. Having a clear plan in place not only provides peace of mind for you but also helps your loved ones navigate difficult situations with confidence and clarity.