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Florida Do Not Resuscitate Order

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State of Florida

DO NOT RESUSCITATE ORDER

(please use ink)

(Print or Type Name)

PATIENT'S STATEMENT

Based upon informed consent, I, the undersigned, hereby direct that CPR be withheld or withdrawn.

(If not signed by patient, check applicable box):

(Applicable Signature)

(Print or Type Name)

PHYSICIAN'S STATEMENT

I, the undersigned, a physician licensed pursuant to Chapter 458 or 459, F.S., am the physician of the patient named above. I hereby direct the withholding or withdrawing of cardiopulmonary resuscitation (artificial ventilation, cardiac compression, endotracheal intubation and defibrillation) from the patient in the event of the patient's cardiac or respiratory arrest.

(Signature of Physician)

(Date)

Telephone Number (Emergency)

(Print or Type Name)

(Physician's Medical License Number)

DH Form 1896, Revised December 2004

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What the Florida Do Not Resuscitate Order Is and when it applies

A Florida Do Not Resuscitate Order (DNR) is a medical directive that instructs health care professionals and emergency responders not to perform cardiopulmonary resuscitation (CPR) or advanced cardiac life support if a patient’s heart or breathing stops. In Florida this instruction is documented as a physician order or an authorized medical order and is intended for patients with terminal illness, advanced chronic conditions, or those who decline resuscitation after informed discussion with clinicians. A properly completed DNR must be accessible to treating personnel and follow state requirements so it is recognized by hospitals, long-term care facilities, and emergency medical services.

Why a Florida DNR Order matters for patients and clinicians

A DNR clarifies a patient’s preferences about resuscitation, reduces unwanted invasive interventions, and supports care aligned with the patient’s goals and medical condition.

Why a Florida DNR Order matters for patients and clinicians

Who completes and relies on a Florida DNR Order

Typical participants in creating and using a DNR include patients, attending physicians, authorized clinicians, and surrogate decision-makers when the patient lacks capacity.

  • Attending physician or authorized clinician — documents the DNR as a medical order and signs to make it official.
  • Patient or legally authorized surrogate — expresses preferences and consents to the physician order when capacity permits or via surrogate authority.
  • Emergency medical services and facility staff — review and follow the order during out-of-hospital and in-hospital events.

Clear roles and correct signatures help ensure the order is followed by EMS, hospital teams, and long-term care providers.

Step-by-step: completing a Florida DNR Order

Follow these sequential steps to prepare a legally effective, clinically useful DNR order that will be recognized by EMS and care facilities.

  • 01
    1. Discuss preferences: Clinician reviews prognosis and treatment options with patient or surrogate.
  • 02
    2. Document medical order: Physician records the DNR as a formal medical order in the chart and on the DNR form.
  • 03
    3. Obtain signatures: Patient or surrogate signs when able; physician signs to validate the order.
  • 04
    4. Share and display: Place order in chart, provide patient copy, and ensure EMS-accessible documentation.

Core elements to include in a professional Florida DNR Order

A complete DNR order contains both clinical direction and administrative details so that responders can identify, verify, and follow the patient’s wishes without ambiguity.

Patient identity

Full name, date of birth, and a unique institutional identifier (MRN or chart number) to ensure correct patient matching in acute settings.

Clear physician directive

A concise order statement such as 'Do Not Resuscitate — No CPR or advanced cardiac life support' with the clinical context noted.

Signatures and dates

Signature lines for the attending physician, patient or surrogate, and corresponding dates to establish validity and timing of the order.

Surrogate authority

If the patient lacks capacity, document surrogate name, relationship, and legal authority to consent under state law.

Visibility instructions

Indicate how the order should be displayed or carried (chart location, wearable ID, or transport documents) to aid EMS and facility staff.

Revision history

Space or fields for amendments, rescissions, and dates so clinicians can track changes to the patient’s resuscitation preferences.

Required data fields and identifiers

Patient Name: Full legal name
Date of Birth: MM/DD/YYYY
Medical Record: Facility MRN or identifier
Physician Name: Printed name of ordering clinician
Signatures: Physician + patient/surrogate
Order Date: MM/DD/YYYY

Where to file and how a Florida DNR order travels with care

Understand the typical routing so the order is accessible across care settings and recognized by EMS during emergencies.

  • Inpatient chart: Place original order in the patient’s hospital chart for inpatient care and nursing staff access.
  • Outpatient record: Upload the order to electronic health record (EHR) problem list or advance directives section for continuity.
  • Patient copy: Provide a printed or digital copy to the patient to carry during transfers or outpatient encounters.
  • EMS notification: Ensure EMS has access through patient-held documents, facility transfer forms, or statewide registries if available.

How to customize and complete a Florida DNR Order online

Configure a digital workflow that collects required fields, captures signatures, and records a timestamped audit trail.

Field Configuration
Patient ID Required, autofill from EHR
Physician signature Require certified signer, include timestamp
Patient consent Optional or required per capacity check
Audit log Store IP, time, and signer authentication

Digital signing and technical requirements for eSubmission

Electronic completion of a DNR is acceptable when the platform complies with federal e-signature law and local facility policy.

  • Authentication: Multi-factor or verified clinician credentials
  • Audit Trail: Tamper-evident log with timestamps
  • HIPAA Controls: Encryption in transit and at rest

Use an e‑sign platform that supports ESIGN/UETA compliance, audit trails, and HIPAA safeguards; integrate with EHRs and document repositories when possible.

Timing considerations and immediate steps after signing

Certain timing actions help ensure the DNR is honored across settings and during transfers; some steps are time-sensitive.

Order effective date:

Date of physician signature; use MM/DD/YYYY

Immediate filing:

Place order in chart before discharge or transport

Patient copy delivery:

Provide copy at time of signing or before discharge

EHR upload:

Within 24–72 hours recommended

Registry submission:

Submit when a regional registry exists

Key milestones from discussion to recognition

Follow these numbered milestones so the DNR is properly authorized, recorded, and accessible when needed.

01

Shared decision conversation

Clinician and patient/surrogate discuss goals and prognosis.

02

Physician order entry

Clinician records the DNR as an official medical order.

03

Signatures obtained

Patient or surrogate and physician sign, dated on form.

04

Distribution and visibility

Order placed in chart, patient copy provided, EMS notified if applicable.

Common pitfalls when preparing a Florida DNR Order

  • Unclear wording that fails to specify CPR and advanced resuscitation limits acceptance by paramedics.
  • Missing physician signature or date can render the order invalid in many care settings.
  • Failure to document surrogate authority when the patient lacks capacity leads to delays or refusal.
  • Not sharing a patient copy or uploading to the EHR prevents EMS and receiving facilities from seeing the order.

Risks and clinical consequences of an incorrect or missing DNR

Unwanted interventions: Patient may receive CPR or intubation contrary to expressed wishes
Legal exposure: Facility or clinician disputes if documentation is incomplete
Care delays: Ambiguity can delay appropriate palliative treatment
Patient distress: Family may experience conflict when orders are unclear
Regulatory risk: Noncompliance with facility policies or state rules
Transfer issues: Receiving facility may not accept an unclear order

Representative eSignature pricing and feature comparison

Compare baseline plan pricing and key capabilities relevant to healthcare forms and HIPAA compliance when selecting an eSignature provider; signNow is listed first per vendor comparison conventions.

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 Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes (Business Premium+) Yes Yes Yes Limited
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions about Florida DNR Orders

Common user questions and straightforward answers to help clinicians, patients, and administrators avoid delays or rejection.


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