Transfer of "do Not Resuscitate" Order Form - Connecticut

Transfer of "do Not Resuscitate" Order Form - Connecticut

Transfer of "do Not Resuscitate" Order Form is a legal document that was released by the Connecticut State Department of Public Health - a government authority operating within Connecticut.

FAQ

Q: What is a Do Not Resuscitate (DNR) order?
A: A DNR order is a medical order that instructs healthcare providers not to perform CPR or other life-sustaining measures on a person in the event of cardiac arrest or respiratory failure.

Q: What is the purpose of a DNR order?
A: The purpose of a DNR order is to respect the wishes of a patient who does not want to receive CPR or other life-sustaining measures.

Q: Who can request a DNR order?
A: A DNR order can be requested by a competent adult or their legal representative.

Q: How can a DNR order be obtained in Connecticut?
A: In Connecticut, a DNR order can be obtained by completing the Transfer of 'Do Not Resuscitate' Order Form, which must be signed by the patient or their legal representative and a healthcare provider.

Q: Can a DNR order be revoked?
A: Yes, a DNR order can be revoked at any time by the patient or their legal representative.

Q: Does a DNR order apply outside of a healthcare facility?
A: No, a DNR order only applies within a healthcare facility. Outside of a healthcare facility, emergency medical responders will provide CPR unless there is a valid DNR order or other legal documentation.

Q: Does a DNR order apply in all healthcare situations?
A: No, a DNR order only applies to the specific situation of cardiac arrest or respiratory failure. Other medical treatments and interventions may still be provided.

Q: Is a DNR order legally binding?
A: Yes, a DNR order is legally binding in Connecticut if properly completed and signed.

Q: Are healthcare providers required to honor a DNR order?
A: Yes, healthcare providers are required to honor a valid DNR order.

Q: Who should be informed about a DNR order?
A: It is important to inform healthcare providers, caregivers, family members, and emergency medical responders about the existence of a DNR order.

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Form Details:

  • Released on October 1, 2002;
  • The latest edition currently provided by the Connecticut State Department of Public Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Public Health.

Download Transfer of "do Not Resuscitate" Order Form - Connecticut

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  • Transfer of do Not Resuscitate Order Form - Connecticut, Page 1
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