Arizona Do Not Resuscitate (DNR) Forms: A Comprehensive Guide & Free Downloadable Template

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Navigating end-of-life care decisions is never easy. One crucial aspect of planning is understanding and completing a Do Not Resuscitate (DNR) form in Arizona. As someone who’s spent over a decade crafting legal and business templates, I’ve seen firsthand how a properly executed DNR can provide peace of mind, ensuring your wishes regarding life-sustaining treatment are honored. This article will provide a detailed overview of Do Not Resuscitate forms in Arizona, explain the legal requirements, and offer a free, downloadable template to help you get started. We'll cover everything from who can create a DNR, to what happens when it's presented to medical professionals, and common pitfalls to avoid. Understanding these forms is vital for all Arizona residents, regardless of age or health status.

What is a Do Not Resuscitate (DNR) Order in Arizona?

A DNR order, formally known as a Physician’s Order Regarding Life-Sustaining Treatment (POLST) in Arizona, is a legal document that instructs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if your heart stops or you stop breathing. CPR includes chest compressions, electric shock, and intubation. It’s important to understand that a DNR doesn’t prevent you from receiving other medical treatments; it specifically addresses resuscitation efforts. It’s a directive about how you want to be treated in a critical situation, not a refusal of all care.

Arizona law (Arizona Revised Statutes Title 36, Chapter 31) recognizes the right of competent adults to make healthcare decisions, including the right to refuse medical treatment. The POLST form is designed to translate those wishes into actionable medical orders. Unlike a living will, which outlines general preferences, a POLST form is a medical order signed by both the patient (or their legal representative) and a physician. This makes it immediately and legally binding.

Who Can Create a Do Not Resuscitate Form in Arizona?

In Arizona, the following individuals are eligible to create a POLST/DNR:

Arizona POLST Form vs. Living Will: What’s the Difference?

Many people confuse a DNR (POLST) with a Living Will. Here’s a breakdown:

Feature POLST (DNR) Living Will (Advance Directive)
Type of Document Medical Order Legal Document outlining wishes
Specificity Specific instructions about resuscitation Broad preferences for end-of-life care
Signatures Required Patient/Representative & Physician Patient & Witnesses
Implementation Immediate medical order Requires interpretation by healthcare providers
Portability Designed to be portable (e.g., EMS) May not be readily accessible in emergencies

The Arizona Department of Health Services (https://www.azdhs.gov/polst/) provides detailed information on both POLST and advance directives.

Completing the Arizona Do Not Resuscitate (POLST) Form: A Step-by-Step Guide

The Arizona POLST form requires careful completion. Here’s a general outline:

  1. Patient Information: Provide your full name, date of birth, and address.
  2. Healthcare Provider Information: Your physician will complete this section, including their name, contact information, and signature.
  3. Treatment Preferences: This is the core of the form. You’ll indicate your wishes regarding CPR, intubation, artificial ventilation, and other life-sustaining treatments. Options typically include “Full Treatment,” “Selective Treatment,” or “Comfort Measures Only.”
  4. Signatures: Both you (or your legal representative) and your physician must sign and date the form.
  5. Distribution: Keep a copy of the signed form with you, give a copy to your physician, and consider providing copies to family members or caregivers. It’s also advisable to inform emergency medical services (EMS) about the existence of the form.

Important Considerations:

Free Downloadable Arizona Do Not Resuscitate (POLST) Template

To help you get started, I’ve created a template based on the official Arizona POLST form. This template is designed to be a starting point and should be reviewed and completed in consultation with your physician.

Download Arizona Do Not Resuscitate (POLST) Template (PDF)

Disclaimer: This template is a sample and may not be suitable for all situations. It is crucial to consult with your physician to ensure the form accurately reflects your wishes and complies with Arizona law.

What Happens When a DNR is Presented to Medical Professionals?

When a valid Arizona DNR (POLST) is presented to healthcare professionals, they are legally obligated to honor the instructions outlined in the form. This means they will not perform CPR if you have indicated that you do not want it. EMS personnel are trained to recognize and respect DNR orders. However, they will still provide other necessary medical care, such as pain management and comfort measures.

It’s important to note that a DNR is not a “do not treat” order. It specifically addresses resuscitation. You will still receive other medical care as needed, unless you have specifically declined it in a separate advance directive.

Common Mistakes to Avoid When Creating a DNR in Arizona

Here are some common errors people make when creating a DNR in Arizona:

Resources for Further Information

Final Thoughts on Arizona Do Not Resuscitate Forms

Creating a Do Not Resuscitate form in Arizona is a proactive step towards ensuring your end-of-life wishes are respected. It’s a difficult conversation to have, but it’s a vital one. By understanding the legal requirements, completing the form carefully, and discussing it with your physician, you can gain peace of mind knowing that your preferences will be honored. Remember to utilize the free template provided as a starting point, but always prioritize professional medical advice.

Disclaimer: I am not a lawyer or medical professional. This article is for informational purposes only and does not constitute legal or medical advice. You should consult with a qualified attorney and your physician to discuss your specific situation and ensure your DNR form is legally valid and reflects your wishes. Laws and regulations are subject to change, so it’s essential to stay informed.