Homepage >> Fillable Do Not Resuscitate Order Template >> Free Do Not Resuscitate Order Form for the State of Texas

Common mistakes

  1. Not Understanding the Purpose: Many individuals fill out the form without fully grasping what a Do Not Resuscitate (DNR) order entails. It’s crucial to recognize that this document indicates a desire to forgo CPR and other life-saving measures in the event of cardiac arrest.

  2. Inadequate Communication: Failing to discuss the DNR order with family members and healthcare providers can lead to confusion. Open conversations ensure that everyone understands the individual's wishes and can advocate for them if necessary.

  3. Incorrect Information: Some people mistakenly provide inaccurate personal information, such as their name, date of birth, or medical history. This can lead to complications in honoring the DNR order when it’s needed.

  4. Not Signing the Form: A common oversight is neglecting to sign the form. Without a signature, the DNR order is not valid, and healthcare providers may be required to perform resuscitation efforts.

  5. Missing Witness Signatures: In Texas, the DNR form must be signed by two witnesses or a notary public. Forgetting this step can invalidate the document, making it ineffective when it’s most needed.

  6. Using an Outdated Form: Individuals sometimes use older versions of the DNR order. It’s essential to ensure that the most current version of the form is being used to comply with state laws and regulations.

  7. Not Keeping Copies Accessible: After filling out the DNR order, some people fail to keep copies in easily accessible locations. It’s important to provide copies to family members, healthcare providers, and keep one in a medical file for emergencies.

Similar forms

A Do Not Resuscitate Order (DNR) is an important document that outlines a person's wishes regarding medical treatment in the event of cardiac arrest or respiratory failure. Several other documents serve similar purposes in guiding medical decisions. Here are eight documents that share similarities with a DNR:

  • Living Will: A living will specifies an individual’s preferences for medical treatment in situations where they are unable to communicate their wishes, particularly concerning life-sustaining measures.
  • Notice to Quit Form: This legal document is crucial for landlords, as it formally informs tenants of the need to vacate the rental property. It is important to understand this document to navigate rights and responsibilities effectively, and more details can be found at azformsonline.com/notice-to-quit/.
  • Durable Power of Attorney for Healthcare: This document allows a person to appoint someone else to make healthcare decisions on their behalf if they become incapacitated, ensuring their wishes are respected.
  • Healthcare Proxy: Similar to a durable power of attorney, a healthcare proxy designates a specific individual to make medical decisions based on the patient’s known wishes or best interests.
  • POLST (Physician Orders for Life-Sustaining Treatment): A POLST form provides specific medical orders for patients with serious illnesses, ensuring that their treatment preferences are clearly documented and followed by healthcare providers.
  • Advance Directive: An advance directive is a broader term that encompasses both living wills and durable powers of attorney, allowing individuals to outline their medical care preferences in advance.
  • Do Not Intubate (DNI) Order: A DNI order specifically indicates that a patient does not wish to be intubated or placed on a ventilator, complementing the wishes expressed in a DNR.
  • Comfort Care Order: This document prioritizes comfort measures over aggressive treatments, ensuring that a patient receives palliative care rather than life-prolonging interventions.
  • End-of-Life Care Plan: This comprehensive plan outlines an individual’s wishes regarding their care during the final stages of life, including preferences for pain management and emotional support.

Each of these documents plays a vital role in ensuring that a person's healthcare preferences are honored, especially during critical moments when they may not be able to express their wishes directly.

Dos and Don'ts

When filling out the Texas Do Not Resuscitate Order form, it’s important to approach the process thoughtfully. Here are some key things to keep in mind:

  • Do ensure that you fully understand the implications of the DNR order before signing.
  • Do consult with your healthcare provider to discuss your wishes and any questions you may have.
  • Don't rush through the form. Take your time to read each section carefully.
  • Don't forget to keep a copy of the completed form for your records and share it with your healthcare team.

Preview - Texas Do Not Resuscitate Order Form

Texas Do Not Resuscitate Order Template

This Do Not Resuscitate (DNR) Order is designed for residents of Texas in accordance with Texas Health and Safety Code, Section 166.202. This document allows an individual to refuse resuscitation in case of a medical emergency.

By signing this DNR order, you are expressing your wishes concerning medical treatments. Please fill in the information below:

  • Patient's Name: _________________________________
  • Date of Birth: _________________________________
  • Address: _______________________________________
  • City: _________________________________________
  • State: Texas
  • Zip Code: _____________________________________

The following individuals may be involved in making medical decisions for you:

  • Designation of Agent or Healthcare Proxy Name: _________________________________________
  • Phone Number: __________________________________

Please indicate your preferences regarding resuscitation:

  • Do Not Resuscitate: I hereby request that my healthcare team not initiate resuscitation measures, including but not limited to CPR, intubation, or advanced cardiac life support.

The choices made in this document are based on my personal values and preferences regarding end-of-life care.

Signatures:

  • Patient's Signature: ___________________________ Date: _____________
  • Witness Signature: ___________________________ Date: _____________
  • Healthcare Provider Signature: _______________ Date: _____________

This DNR Order should be kept in an easily accessible location and a copy should be provided to your healthcare provider and any designated surrogate decision-makers.

For any questions or concerns regarding your DNR Order, please consult with a qualified healthcare attorney or medical professional.

Misconceptions

The Texas Do Not Resuscitate Order (DNR) form is often misunderstood. Below are some common misconceptions along with clarifications.

  • A DNR means no medical care will be provided. This is incorrect. A DNR specifically addresses resuscitation efforts in the event of cardiac arrest or respiratory failure. Other medical treatments and care can still be provided.
  • A DNR is only for terminally ill patients. This misconception is not accurate. While many people who choose a DNR may have serious health conditions, anyone can request a DNR regardless of their health status.
  • Once a DNR is signed, it cannot be changed. This is false. A DNR can be revoked or modified at any time by the patient or their legal representative, as long as the change is documented appropriately.
  • Emergency responders will ignore a DNR order. This is misleading. Emergency responders are trained to respect valid DNR orders. They will assess the situation and follow the instructions outlined in the DNR form.

How to Use Texas Do Not Resuscitate Order

Filling out the Texas Do Not Resuscitate Order form is an important step in ensuring that your medical preferences are honored. This document allows individuals to express their wishes regarding resuscitation in the event of a medical emergency. To proceed, follow the steps outlined below carefully.

  1. Obtain the Texas Do Not Resuscitate Order form. This can typically be found online or through a healthcare provider.
  2. Begin by filling in your full name at the top of the form.
  3. Provide your date of birth and any other personal identification information requested.
  4. Indicate the name of your physician or healthcare provider who will be overseeing your care.
  5. Clearly state your wishes regarding resuscitation in the designated section of the form.
  6. Sign and date the form to validate your instructions.
  7. If applicable, have your physician sign the form to confirm that they understand and support your wishes.
  8. Make copies of the completed form for your records and provide a copy to your healthcare provider, family members, and any other relevant parties.

Once you have completed the form, it is essential to communicate your wishes to your loved ones and healthcare team. This ensures that everyone involved is aware of your preferences and can act accordingly in the event of a medical emergency.