Printable Do Not Resuscitate Order Form for the State of Georgia Get Document

Printable Do Not Resuscitate Order Form for the State of Georgia

A Georgia 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 medical personnel respect the individual's preferences concerning life-sustaining treatments. For those considering this important decision, filling out the form can provide clarity and peace of mind; click the button below to get started.

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Outline

In the state of Georgia, the Do Not Resuscitate (DNR) Order form serves as a crucial tool for individuals who wish to express their preferences regarding medical interventions during a life-threatening situation. This legal document allows patients to communicate their desire to forgo resuscitation efforts, such as CPR or advanced cardiac life support, in the event of cardiac arrest or respiratory failure. By completing this form, individuals can ensure that their wishes are respected by healthcare providers, relieving family members of the burden of making difficult decisions during emotionally charged moments. The DNR Order is recognized across various healthcare settings, including hospitals, nursing homes, and home care environments, making it an essential component of end-of-life planning. Additionally, it is important to understand the process of obtaining and completing the form, as well as the implications it carries for both patients and their loved ones. Understanding these aspects can empower individuals to make informed decisions about their healthcare preferences, fostering a sense of control and peace of mind during challenging times.

Key takeaways

Filling out a Do Not Resuscitate (DNR) Order form in Georgia is an important step for individuals who wish to communicate their medical preferences. Here are some key takeaways to keep in mind:

  • The DNR Order form must be signed by a licensed physician. This ensures that your wishes are legally recognized.
  • It is essential to have a clear understanding of what a DNR Order entails. It means that if your heart stops or you stop breathing, medical personnel will not perform CPR.
  • You should discuss your decision with family members and your healthcare provider. Open communication helps everyone understand your wishes.
  • Once completed, keep the DNR Order in a visible location, such as on your refrigerator or with your other important documents. This makes it easy for emergency responders to find.
  • Consider carrying a wallet card that indicates you have a DNR Order. This can alert medical personnel quickly in case of an emergency.
  • Review your DNR Order periodically. Your health status and preferences may change over time, so it’s important to ensure the document reflects your current wishes.
  • Know that you have the right to revoke or change your DNR Order at any time. Simply notify your physician and update your documents accordingly.

Form Preview Example

Georgia Do Not Resuscitate (DNR) Order

This Do Not Resuscitate Order is established in accordance with the laws of the State of Georgia, specifically the Official Code of Georgia Annotated (O.C.G.A.) § 31-39. It is intended to instruct healthcare providers regarding the medical wishes of the individual named below.

Patient Information:

  • Patient's Full Name: ______________________________
  • Date of Birth: ______________________________
  • Address: ______________________________
  • City, State, Zip Code: ______________________________

Declaration:

I, the undersigned, hereby declare that in the event of cardiac arrest or respiratory failure, I do not want resuscitation efforts to be initiated. This includes, but is not limited to, any attempt to restart my heart or to restore my breathing.

Patient's Preference:

By signing this order, I affirm that this decision reflects my personal values and choices regarding life-sustaining treatment. I understand that this order enables my healthcare providers to honor my wishes.

Designated Healthcare Agent (if applicable):

  • Name: ______________________________
  • Relationship to Patient: ______________________________
  • Contact Number: ______________________________

Signatures:

  1. Patient's Signature: ______________________________ Date: _______________
  2. Witness Signature: ______________________________ Date: _______________

This order should be made available to all healthcare providers involved in the patient's care. A copy of this order must also accompany the patient if they are transferred to another facility.

It is advisable to review this order periodically and update it as necessary to reflect the patient’s current wishes.