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Utah Do Not Resuscitate (DNR) Order Form

A Utah Do Not Resuscitate (DNR) order form informs medical personnel not to administer CPR on a patient if they experience heart or breathing failure. A more comprehensive version of a DNR form has been implemented in Utah, called the "POLST" form. It details the patient's approved resuscitative measures and medical interventions.
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  • Laws – R432-31
  • Required to Sign (POLST) – MD/DO/PA/APRN, and patient (or representative).

Sample