Legal  Do Not Resuscitate Order Form for Colorado Customize Do Not Resuscitate Order Now

Legal Do Not Resuscitate Order Form for Colorado

A Colorado Do Not Resuscitate (DNR) Order 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 if a person experiences a cardiac arrest or respiratory failure, medical personnel will honor their decision to forgo life-saving measures. Understanding this form is crucial for individuals seeking to maintain control over their medical treatment preferences at the end of life.

In the realm of healthcare, understanding the nuances of end-of-life decisions is crucial for both patients and their families. One significant document that plays a pivotal role in these discussions is the Colorado Do Not Resuscitate (DNR) Order form. This form empowers individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency, ensuring that their preferences are respected. It is designed for patients who have a terminal condition or are facing a serious illness, allowing them to make informed choices about their care. The DNR Order must be signed by a physician, confirming that the patient is fully aware of the implications of their decision. Additionally, it requires the patient’s signature or that of a legally authorized representative, reinforcing the importance of consent. By clearly outlining the patient’s wishes, the Colorado DNR Order form not only provides peace of mind but also facilitates communication among healthcare providers, family members, and caregivers, ensuring everyone is aligned with the patient’s desires during critical moments.

Document Example

Colorado Do Not Resuscitate Order Template

This Do Not Resuscitate (DNR) Order is designed for use in the state of Colorado. It helps to express your preferences about medical interventions in case of a health crisis.

Under Colorado law, individuals have the right to make decisions about their medical care, including the right to decline resuscitation efforts. This document should be filled out accurately and kept in a visible location.

By signing this DNR Order, I, the undersigned, wish to communicate my desire not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest.

Patient Information:

  • Full Name: ____________________________
  • Date of Birth: ________________________
  • Address: _____________________________
  • City, State, ZIP: ____________________

Health Care Provider Information:

  • Provider's Name: ____________________
  • Provider's Phone Number: ______________
  • Provider's Address: __________________

Patient's Wishes: I do not want any resuscitation attempts, including but not limited to:

  1. Chest Compressions
  2. Intubation
  3. Defibrillation

Signature:

By signing below, I confirm that I understand the implications of this order:

Signature of Patient or Authorized Representative: _____________________________

Date: ____________________________

Witness Information:

  • Name of Witness: ____________________
  • Signature of Witness: ________________
  • Date: ____________________________

Please keep a copy of this DNR Order in a prominent location and share it with your healthcare providers and family members.

Documents used along the form

When considering end-of-life care, it’s important to have a variety of documents in place alongside the Colorado Do Not Resuscitate (DNR) Order form. These documents help ensure that your healthcare wishes are honored and provide clarity for medical professionals and family members. Below is a list of other commonly used forms and documents that complement a DNR order.

  • Advance Healthcare Directive: This document outlines your preferences for medical treatment if you become unable to communicate your wishes. It can include specific instructions about life-sustaining treatments.
  • Durable Power of Attorney for Healthcare: This allows you to designate someone to make healthcare decisions on your behalf if you are incapacitated. The appointed person can ensure your wishes are followed.
  • Living Will: A living will specifies what types of medical treatment you do or do not want in certain situations, particularly when facing terminal illness or irreversible conditions.
  • Physician Orders for Life-Sustaining Treatment (POLST): This form translates your treatment preferences into actionable medical orders. It is especially useful for those with serious health conditions.
  • Healthcare Proxy: Similar to a durable power of attorney, this document names a specific person to make healthcare decisions for you when you cannot make them yourself.
  • Organ Donation Form: This document indicates your wishes regarding organ donation after death. It can be included with your DNR order to clarify your intentions.
  • Do Not Intubate (DNI) Order: This is a specific medical order that indicates you do not want to be intubated if you cannot breathe on your own, complementing the DNR order.
  • Patient Advocate Form: This form allows you to designate someone to advocate for your healthcare preferences, ensuring your wishes are communicated effectively to medical staff.

Having these documents in place can provide peace of mind for both you and your loved ones. They work together to create a comprehensive plan that reflects your values and preferences regarding medical care. It’s advisable to review these forms regularly and discuss them with your family and healthcare providers.

Other Colorado Forms

How to Fill Out Colorado Do Not Resuscitate Order

Filling out the Colorado Do Not Resuscitate Order form is an important step in expressing your medical wishes. This process allows you to ensure that your preferences are respected in a medical emergency. Here’s how to complete the form effectively.

  1. Obtain the Colorado Do Not Resuscitate Order form. You can find it on the Colorado Department of Public Health and Environment's website or through healthcare providers.
  2. Read the instructions carefully. Understanding the form will help you fill it out correctly.
  3. Fill in your full name, date of birth, and address at the top of the form. This information identifies you clearly.
  4. Indicate the date you are completing the form. This helps to establish the validity of your wishes.
  5. Sign the form. Your signature is essential as it confirms that you are making this decision voluntarily.
  6. Have a witness sign the form. The witness should be someone who is not a family member or your healthcare provider.
  7. Make copies of the completed form. Keep one for your records and provide copies to your healthcare provider and family members.
  8. Discuss your wishes with your healthcare provider. This ensures that they are aware of your preferences and can act accordingly.

Once you have completed the form, it’s important to store it in a safe place and share it with those who may need to know your wishes. Open communication with your loved ones and healthcare providers will help ensure that your preferences are honored when it matters most.

Similar forms

The Colorado Do Not Resuscitate (DNR) Order form shares similarities with the Advance Directive. An Advance Directive is a legal document that allows individuals to outline their preferences for medical treatment in the event they become unable to communicate their wishes. Like the DNR, it provides clarity to healthcare providers about the patient’s desires regarding life-sustaining measures. Both documents aim to ensure that a person's healthcare choices are respected, even when they cannot voice those choices themselves.

Another document that resembles the DNR is the Medical Power of Attorney. This legal instrument designates a specific person to make healthcare decisions on behalf of an individual if they are incapacitated. While the DNR focuses specifically on resuscitation efforts, the Medical Power of Attorney encompasses a broader range of medical decisions. Both documents emphasize the importance of personal autonomy and the need for clear communication regarding medical preferences.

The Living Will is also similar to the DNR Order. This document allows individuals to express their wishes regarding end-of-life care and medical treatments they do or do not want. While the DNR specifically addresses resuscitation, the Living Will can cover various scenarios, such as life support or pain management. Both serve to guide healthcare providers in making decisions that align with the patient’s values and wishes.

The Physician Orders for Life-Sustaining Treatment (POLST) form is another document akin to the DNR. POLST is designed for individuals with serious illnesses and translates their preferences for treatment into actionable medical orders. Similar to the DNR, it provides clear instructions to medical personnel regarding resuscitation and other life-sustaining interventions. Both documents aim to ensure that patients receive care that aligns with their personal wishes and medical conditions.

In addition, the Do Not Intubate (DNI) order is closely related to the DNR. A DNI specifically instructs healthcare providers not to perform intubation or provide mechanical ventilation in the event of respiratory failure. While the DNR addresses cardiac arrest and resuscitation efforts, the DNI focuses on breathing support. Both documents reflect a patient’s wishes regarding critical interventions, helping to guide treatment decisions in emergencies.

Lastly, the Comfort Care Order shares similarities with the DNR. This document prioritizes comfort and quality of life over aggressive medical interventions. While the DNR emphasizes the refusal of resuscitation efforts, the Comfort Care Order ensures that patients receive palliative care aimed at alleviating suffering. Both documents underscore the importance of respecting individual choices regarding the type of care they wish to receive during serious health challenges.

Frequently Asked Questions

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

A Colorado Do Not Resuscitate Order (DNR) form is a legal document that allows a person to express their wishes regarding resuscitation efforts in the event of a medical emergency. It specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) or other life-saving measures if the individual’s heart stops or they stop breathing.

Who can complete a DNR form in Colorado?

In Colorado, any adult who is capable of making their own medical decisions can complete a DNR form. This includes individuals who are 18 years or older and are of sound mind. Additionally, a parent or legal guardian may complete a DNR form on behalf of a minor.

How do I obtain a DNR form in Colorado?

You can obtain a Colorado DNR form from several sources:

  • Your healthcare provider or hospital.
  • The Colorado Department of Public Health and Environment website.
  • Various legal and healthcare organizations that provide resources for advance care planning.

What are the steps to complete a DNR form?

Completing a DNR form involves the following steps:

  1. Obtain the form from a reliable source.
  2. Fill out the form with your personal information and preferences regarding resuscitation.
  3. Sign the form in the presence of a witness or a notary, if required.
  4. Provide copies to your healthcare provider, family members, and keep one for yourself.

Is a DNR form legally binding in Colorado?

Yes, a properly completed and signed DNR form is legally binding in Colorado. Healthcare providers are required to honor the wishes outlined in the form, as long as it is valid and complies with state laws. It is important to ensure that the form is completed correctly to avoid any confusion during a medical emergency.

Can I change or revoke my DNR order?

Yes, you can change or revoke your DNR order at any time. To do this, you should destroy the original form and notify your healthcare provider and family members of your decision. If you wish to create a new DNR order, follow the same steps as before to ensure it is properly documented.

What should I do if I am in a hospital or care facility?

If you are in a hospital or care facility, it is essential to discuss your DNR wishes with your healthcare team. They can assist you in completing the DNR form and ensure it is placed in your medical records. Communicating your wishes clearly helps ensure that your preferences are respected during your care.

Dos and Don'ts

When filling out the Colorado Do Not Resuscitate Order form, it's essential to approach the process with care. Here are seven important guidelines to follow:

  • Do ensure you understand the implications of a Do Not Resuscitate (DNR) order. It is crucial to know what this decision entails for your medical care.
  • Do discuss your wishes with your healthcare provider and family members. Open communication can prevent confusion and ensure everyone is on the same page.
  • Do fill out the form completely. Incomplete forms may lead to misunderstandings or improper implementation of your wishes.
  • Do sign and date the form. Your signature is necessary for the order to be valid.
  • Don’t forget to keep copies of the signed DNR order. Distributing copies to your healthcare providers and loved ones is advisable.
  • Don’t assume verbal instructions are enough. A written DNR order is legally required to ensure your wishes are honored.
  • Don’t hesitate to ask questions if you are unsure about any part of the form or the process. Clarity is key to making informed decisions.