Official Do Not Resuscitate Order Form for Wyoming

Official Do Not Resuscitate Order Form for Wyoming

A Wyoming Do Not Resuscitate 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 healthcare providers respect the patient's preferences about life-sustaining treatments. To take control of your healthcare decisions, consider filling out the form by clicking the button below.

Fill Out Do Not Resuscitate Order Here

The Wyoming Do Not Resuscitate (DNR) Order form serves as a critical legal document for individuals who wish to communicate their preferences regarding resuscitation efforts in the event of a medical emergency. This form is particularly important for patients with terminal illnesses or those who wish to avoid aggressive life-saving measures that may not align with their values or quality of life. The DNR Order must be completed and signed by a licensed physician, ensuring that the decision is made with medical guidance. Additionally, the form requires the signature of the patient or their legal representative, thereby affirming the individual’s autonomy in making healthcare decisions. It is essential for patients to discuss their wishes with family members and healthcare providers, as this facilitates understanding and respect for the patient's choices. The completed DNR Order should be readily accessible in medical records and at home, allowing emergency personnel to act according to the patient's wishes without delay. Understanding the implications and proper usage of the Wyoming DNR Order form can empower individuals to take control of their healthcare decisions, ensuring that their preferences are honored in critical situations.

Document Specifics

Fact Name Details
Governing Law The Wyoming Do Not Resuscitate Order form is governed by Wyoming Statutes § 35-21-1001 through § 35-21-1004.
Purpose This form allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency.
Eligibility Any competent adult may complete a Do Not Resuscitate Order, or a parent or guardian may do so on behalf of a minor.
Signature Requirement The form must be signed by the individual or their authorized representative, and it requires a witness signature to be valid.

Key takeaways

When considering the Wyoming Do Not Resuscitate (DNR) Order form, it’s essential to understand its significance and the proper way to fill it out. Here are some key takeaways:

  • The DNR Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  • It is crucial to have a conversation with your healthcare provider before completing the form to ensure that your wishes are clearly understood.
  • Make sure to fill out the form accurately, including your personal information and the signatures of witnesses, as required.
  • Once completed, keep the DNR Order in a visible location, such as on the refrigerator or with other important medical documents.
  • Provide copies of the DNR Order to your healthcare provider, family members, and anyone else involved in your care.
  • The DNR Order can be revoked at any time. If you change your mind, simply destroy the old form and inform your healthcare provider.
  • Review the DNR Order regularly, especially if your health status changes or if you have new healthcare preferences.
  • Understand that the DNR Order only applies to resuscitation efforts. It does not affect other types of medical treatment you may receive.

Wyoming Do Not Resuscitate Order Example

Wyoming Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is made in accordance with Wyoming state laws regarding advance directives and medical treatment preferences.

Please complete the following information to ensure your wishes are understood and respected.

  • Patient Name: ___________________________
  • Date of Birth: ___________________________
  • Address: _______________________________
  • Emergency Contact Name: _________________
  • Emergency Contact Phone Number: __________

The purpose of this order is to indicate that the patient does not wish to receive cardiopulmonary resuscitation (CPR) if the heart stops beating or if breathing ceases.

Please mark the appropriate box:

  • ☐ I do not want to be resuscitated.
  • ☐ I want to withhold resuscitation in the event of cardiac arrest.

Signature of Patient or Legal Representative: ___________________________

Date: ___________________________

Witness Signature: ___________________________

Date: ___________________________

This DNR Order should be presented to medical personnel and kept in an accessible location. It is important to ensure that all involved parties are aware of this document to honor the patient's wishes.

Important Facts about Wyoming Do Not Resuscitate Order

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

A Wyoming Do Not Resuscitate Order is a legal document that allows individuals to refuse resuscitation efforts in the event of a medical emergency. This form is particularly relevant for patients with terminal illnesses or severe medical conditions. By completing a DNR, a person expresses their wish not to receive cardiopulmonary resuscitation (CPR) or other life-saving measures if their heart stops or they stop breathing.

Who can complete a DNR form in Wyoming?

In Wyoming, any adult who is capable of making informed decisions about their medical care can complete a DNR form. This includes individuals diagnosed with a terminal illness or those who have a clear understanding of their medical condition and the implications of a DNR. Additionally, a legal guardian or an authorized healthcare representative can also complete the form on behalf of an individual who is unable to do so.

How do I obtain a DNR form in Wyoming?

A DNR form can typically be obtained from healthcare providers, hospitals, or online resources provided by the Wyoming Department of Health. It is essential to ensure that the form is the official state version to meet legal requirements. Once acquired, the form must be filled out accurately and signed by the individual and a physician to be considered valid.

What should I do after completing the DNR form?

After completing the DNR form, it is crucial to share copies with your healthcare provider, family members, and anyone involved in your care. Keeping a copy in a readily accessible location, such as a medical file or on your refrigerator, can help ensure that emergency personnel are aware of your wishes. Regularly reviewing and updating the form is also advisable, especially if there are changes in your health status or personal preferences.

Documents used along the form

When considering end-of-life care and medical decisions, the Wyoming Do Not Resuscitate (DNR) Order form is just one piece of the puzzle. Several other documents can complement a DNR order, ensuring that your wishes are respected and that your healthcare preferences are clearly communicated. Here’s a brief overview of some important forms you might encounter.

  • Advance Healthcare Directive: This document outlines your preferences for medical treatment in situations where you cannot communicate your wishes. It can include instructions about life-sustaining treatments, pain management, and other healthcare decisions.
  • Healthcare Power of Attorney: This form allows you to designate someone you trust to make medical decisions on your behalf if you become unable to do so. It’s essential to choose someone who understands your values and wishes.
  • Living Will: A living will specifically addresses your preferences regarding life-sustaining treatment. It provides guidance to healthcare providers about the types of care you want or do not want in critical situations.
  • Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that translates your treatment preferences into actionable orders for healthcare providers. It is especially useful for individuals with serious illnesses or those nearing the end of life.
  • Do Not Intubate (DNI) Order: Similar to a DNR, a DNI order specifically indicates that you do not want to be placed on a ventilator if you cannot breathe on your own. This document can be part of a broader advance directive.
  • Durable Power of Attorney: To ensure your healthcare decisions are honored, consider utilizing the key Durable Power of Attorney document that allows another individual to make decisions on your behalf during incapacity.
  • Organ Donation Form: If you wish to donate your organs after death, this form allows you to express your intentions. It can be included in your advance healthcare directive or completed separately.

Understanding these documents can empower you to make informed decisions about your healthcare. It’s crucial to discuss your preferences with family members and healthcare providers to ensure everyone is on the same page. By having these forms in place, you can help ensure that your wishes are honored when it matters most.

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Dos and Don'ts

When filling out the Wyoming Do Not Resuscitate Order form, it’s essential to ensure accuracy and clarity. Here are some important dos and don’ts to keep in mind:

  • Do consult with a healthcare provider before completing the form to understand its implications.
  • Do ensure that the form is signed by the patient or their authorized representative.
  • Do keep a copy of the completed form for your records.
  • Do provide copies to your healthcare team and any family members involved in your care.
  • Do review the form regularly to ensure it still reflects your wishes.
  • Don’t use the form if you have not fully understood its contents and consequences.
  • Don’t forget to date the form when it is signed.
  • Don’t leave any sections of the form blank, as this may cause confusion.
  • Don’t assume that verbal communication of your wishes is sufficient; a written order is necessary.