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Arizona Do Not Resuscitate (DNR) Order Form

The Arizona Do Not Resuscitate (DNR) order form directs healthcare providers not to administer Cardio Pulmonary Resuscitation (CPR) to the patient identified in the document in the event that they stop breathing or experience heart failure.
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  • Laws – § 36-3251
  • Format – Arizona law states that a valid DNR must be on letter or wallet-sized paper, and printed on an orange background.
  • Required to Sign – Patient, licensed physician, and a witness.

Sample