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Indiana Do Not Resuscitate (DNR) Order Form

The Indiana Do Not Resuscitate order form (DNR) is used by individuals who do not want to be resuscitated should they experience cardiac arrest or breathing failure. Qualified individuals include those who have a terminal illness or medical condition that would be exacerbated by CPR or other resuscitation procedures.
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  • Laws§ 16-36-5
  • Required to Sign – Patient, physician and two witnesses.

Sample