Can the directive be signed electronically?

Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states when intent, consent, attribution, and retention are met. For consumer-facing healthcare records, follow ESIGN consumer disclosure rules when required.

Are witnesses or notarization required?

Requirements vary by state and facility. Some organizations accept a signer’s witnessed signature or notarization for additional assurance; confirm local statute or facility policy before relying on the directive.

How do I revoke or change the directive?

Revocation generally requires a signed written statement, a new directive, or clear oral communication to treating providers. Communicate revocation to the medical record, clinicians, and named agent to ensure it is followed.

What if EMS encounters the patient without documentation?

EMS will follow standard resuscitation protocols absent acceptable documentation. Keep copies readily available and ensure facilities and family members have copies to reduce on-scene uncertainty.

Can a surrogate sign on behalf of the patient?

A legally authorized surrogate may act when the patient lacks capacity, but the surrogate must present proof of authority and act according to the patient’s known wishes and applicable state law.

How should I store the signed directive?

Store the original in the medical record and give copies to the agent and family. For electronic storage, use encrypted systems with audit trails; HIPAA-covered entities must preserve access and retention per 45 CFR §164.530(j).

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Colorado Directive to Withhold CPR

Colorado Directive to Withhold CPR

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

What the Colorado Directive to Withhold CPR Is

Colorado Directive to Withhold CPR is a written instruction that records a person’s decision to withhold cardiopulmonary resuscitation (CPR) under specified clinical conditions. It is used in advance care planning to state preferences about emergency resuscitation when a patient lacks capacity or is receiving comfort-focused care. The directive works alongside other advance directives and medical orders and must be completed following Colorado law, facility policy, and applicable federal privacy rules such as HIPAA.

Why a Clear CPR Directive Matters

A Colorado Directive to Withhold CPR documents patient wishes, reduces unwanted emergency interventions, and guides clinicians under pressure. It supports consistency across settings, clarifies decision-making for surrogates, and helps hospitals and EMS align care with the patient’s goals while maintaining required privacy protections.

Who Typically Completes This Directive

Common users complete a Colorado Directive to Withhold CPR to document treatment preferences and avoid uncertainty in emergencies.

Patients with advanced illness, terminal diagnoses, or limited life expectancy making end-of-life care decisions
Health care agents or legally authorized surrogates who must sign when the patient lacks capacity
Hospices, long-term care facilities, and hospitals that record and honor patient directives

Primary Signers and Authorities

Patient — Declarant

An adult with capacity who completes the Colorado Directive to Withhold CPR to record personal CPR preferences. The declarant should use a full legal name, specify triggering clinical conditions, sign and date the form, and confirm capacity before witnesses or a notary if local policy requires it.

Healthcare Agent

A named proxy under a health care power of attorney who may confirm or execute the directive when the declarant lacks capacity. The agent must act according to the patient’s known wishes, present proof of authority if requested, and follow applicable state legal standards.

Step-by-Step: Completing the Colorado Directive to Withhold CPR

Use these sequential steps to complete the directive correctly and speed acceptance by providers and emergency responders.

01

Verify identity: Provide government-issued ID and confirm the declarant’s full legal name.
02

Describe conditions: Specify exact clinical situations and any limitations to withholding CPR.
03

Sign and date: Declarant or authorized agent signs and dates; obtain witnesses or notary if required.
04

Distribute copies: Give signed copies to clinicians, the health care agent, and add to the medical record.

Where to Send or File the Completed Directive

After signing, route the Colorado Directive to Withhold CPR to clinical records, the patient’s care team, the authorized surrogate, and any registry the facility uses for advance directives.

Medical Record: Provide to the admitting hospital or clinic records department for immediate chart placement.
Primary Clinician: Share with the patient’s primary care physician and treating specialists.
Surrogate: Deliver a signed copy to the named healthcare agent and close family members.
Facility Registry: Upload to a facility or statewide advance directive registry when available.

Configuring an Online Form for the Directive

Set up an online workflow to collect required fields, authenticate signers, and route copies automatically when the Colorado Directive to Withhold CPR is completed.

Field	Configuration
Identity verification	Email plus optional SMS OTP or identity credential check
Signature type	Electronic signature with audit trail; RON optional where permitted
Conditional fields	Display clinical condition fields only when 'Withhold CPR' is chosen
Notifications	Auto-email signed copies to agent and medical records

How to Share the Directive Securely

Choose secure delivery channels and integrations so providers and registries receive the Colorado Directive to Withhold CPR without exposing PHI.

EHR Integration: Direct upload to Epic, Cerner, or equivalent via HL7 or API
Secure Email: Encrypted email or patient portal delivery to authorized recipients
Cloud Storage: Save to Box, Google Drive, or provider repository with access controls

Timing Considerations and When to Review

Although a CPR directive takes effect on signature, regular review and re-acknowledgment can prevent conflicts; update after major health changes or care transitions.

Effective date:

Directive is effective when signed and dated by the declarant or authorized agent

Care transitions:

Review and refile the directive upon hospital admission or transfer

Periodic review:

Revisit annually or after significant clinical changes to confirm continued intent

Agent activation:

Agent actions begin when the patient lacks decision-making capacity under applicable law

Revocation timing:

Revocation is effective when communicated to treating providers or by executing a new directive

Key Elements Every Professional Directive Should Include

A professionally prepared Colorado Directive to Withhold CPR is concise, specific, and includes verifiable signatory and clinical information so health teams can act confidently.

Declarant identity

Full legal name, date of birth, and contact details to avoid misidentification and to locate existing medical records.

Clear instruction

Unambiguous language stating CPR is to be withheld under defined clinical conditions to minimize interpretation disputes.

Triggering conditions

Specific clinical scenarios or diagnoses that activate the directive, such as irreversible terminal decline or permanent unconsciousness.

Signature block

Signature, printed name, date, and space for witnesses or notary if required by local policy.

Provider acknowledgment

Area for clinician to document review and place an operational order in the medical chart when appropriate.

Distribution list

Designated recipients including surrogate, primary clinician, and medical records for consistent access across settings.

Common Pitfalls to Avoid When Preparing the Directive

Vague language such as 'no extraordinary measures' can create confusion and lead to unwanted resuscitation attempts.
Using initials instead of a full signature or omitting the date can render the directive unenforceable or delay verification.
Failing to provide a copy to the medical record, treating clinicians, and the named agent increases the risk the directive will not be followed.
Not updating or revoking the directive in writing after a change of intent can result in conflicts between family and providers.

Risks if the Directive Is Incorrect or Misapplied

Unenforceable directive: Unenforceable if not signed correctly

Conflicting orders: Conflict with POLST or existing physician orders

Care delays: Treatment delayed during validation

Provider liability: Increased legal risk from disputed instructions

Privacy exposure: Risk of HIPAA violation if PHI is improperly shared

Ineffective revocation: Revocation not effective if improperly executed

Illustrative Use Cases

Real-world workflows show how a clear directive reduces clinician uncertainty and speeds appropriate end-of-life care decisions.

Hospice Program

A hospice coordinator collects signed directives on admission to ensure goals of care are honored

Coordination with the primary physician reduces emergency resuscitation attempts
The result: faster alignment of care with patient wishes and fewer hospital transfers during terminal decline.

Long-Term Care Facility

A nursing home records directives in the resident chart and notifies EMS of CPR preferences

Staff place a visible directive summary at bedside
This practice decreases inappropriate resuscitation attempts and clarifies decisions during 911 responses.

Practical Tips for Accurate, Efficient Completion

Adopt consistent procedures and clear wording to reduce errors, speed verification, and improve adherence to patient wishes.

Use precise clinical triggers

Avoid generalities. Specify conditions such as 'irreversible terminal illness' or 'permanent unconsciousness' so clinicians can apply the directive without subjective interpretation.

Verify signer authority

Confirm the declarant’s capacity or validate surrogate authority with a durable power of attorney for healthcare before accepting or applying the directive.

Maintain audit trails

Record when and where copies were distributed, who acknowledged receipt, and any clinician entries so disputes can be resolved quickly.

Integrate with records

Ensure the signed directive is uploaded to the EHR and available to EMS through facility protocols or registries to avoid contradictory on-scene decisions.

eSignature Vendor Pricing Snapshot for Directive Workflows

Common eSignature vendors vary by price, trial terms, and compliance features; signNow is listed first to show plan comparisons for secure directive signing.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial, no card	Varies; vendor trial available	Varies; vendor trial available	Varies; vendor trial available	Varies; vendor trial available
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently Asked Questions

Answers to common questions about completing, signing, distributing, and revoking a Colorado Directive to Withhold CPR.

Need help? Contact support

Can the directive be signed electronically?
Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states when intent, consent, attribution, and retention are met. For consumer-facing healthcare records, follow ESIGN consumer disclosure rules when required.
Are witnesses or notarization required?
Requirements vary by state and facility. Some organizations accept a signer’s witnessed signature or notarization for additional assurance; confirm local statute or facility policy before relying on the directive.
How do I revoke or change the directive?
Revocation generally requires a signed written statement, a new directive, or clear oral communication to treating providers. Communicate revocation to the medical record, clinicians, and named agent to ensure it is followed.
What if EMS encounters the patient without documentation?
EMS will follow standard resuscitation protocols absent acceptable documentation. Keep copies readily available and ensure facilities and family members have copies to reduce on-scene uncertainty.
Can a surrogate sign on behalf of the patient?
A legally authorized surrogate may act when the patient lacks capacity, but the surrogate must present proof of authority and act according to the patient’s known wishes and applicable state law.
How should I store the signed directive?
Store the original in the medical record and give copies to the agent and family. For electronic storage, use encrypted systems with audit trails; HIPAA-covered entities must preserve access and retention per 45 CFR §164.530(j).

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