At Speedy Template, You can download Nebraska Dakota Do Not Resuscitate Form . There are a few ways to find the forms or templates you need. You can choose forms in your state, use search feature to find the related forms. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.
PHYSICIAN’S DO NOT RESUSCITATE (DNR) ORDER FOR THE MEDICALLY ILL
I, _____________________________________ , have been diagnosed as having a medical illness. I have discussed both the
prognosis of this illness and the treatment options with my physician and request that in the event of my
cardiopulmonary arrest, cardiopulmonary resuscitation and/or mechanical ventilations not be initiated.
I give permission for this information to be given to Emergency Medical Service and Mobile Health Care personnel,
physicians, nurses, or other health care personnel as necessary to carry out these wishes. I understand that this order
is valid from this point forward until rescinded by either myself or my designated Durable Power of Attorney for Health
Care, and further agree that a copy of this form is as valid as the original. Incomplete forms may be returned as being
□DO NOT INTUBATE I understand that DO NOT INTUBATE means that in the event that my breathing is inadequate
I do not wish a tube placed in my airway to maintain my respirations artificially.
□DO NOT RESUSCITATE (DNR) I understand that DNR means that if my heart stops beating, or is inadequate, or that
if I stop breathing or my breathing is inadequate, that no artificial resuscitation will be initiated or continued. I
understand that I will continue to receive supportive medical care as deemed appropriate by health care personnel,
though cardiopulmonary resuscitation will not take place.
Speedy Template provides all kinds of legal templates, forms and waivers in different editable formats. Use the template search on the top to find the customized templates that fit your needs with absolutely no cost. Those templates are collected online so we do not claim the ownership of those templates. You can think this website as a legal document search portal and use it to find the printable templates and download them to your local computers and make appropriate adjustments from your end. There is no need to create an account or provide your credit card information. Feel free to download those Word, Excel, PowerPoint or PDF files while we continue to improve this website. Hope you can find those free printable templates useful for business or personal purposes.