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New Mexico Do Not Resuscitate (DNR) Order Form

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New Mexico Do Not Resuscitate (DNR) Order Form

Updated July 19, 2023

A New Mexico do not resuscitate (DNR or DNAR) order form is issued by a physician on behalf of an adult resident (18 years of age or older) after they have properly explained its significance to the patient. This document instructs emergency medical personnel not to attempt resuscitation in the event that the patient’s breathing or heart stops. One (1) signed copy of a DNR order should be kept by the patient and another copy kept by the physician, filed in the patient’s medical record. If the patient would like a DNR bracelet, they will need a third copy of their DNR order and to enroll in MedicAlert with their physician’s assistance. At any point, the order may be revoked by the patient or an authorized representative’s verbal command, or by being physically destroyed. If a DNR order is revoked, the patient’s physician should be informed immediately.

Laws – § and §24-10B-4I

Required to Sign – Physician and patient (or authorized representative) must sign.

How to Write

Step 1 – Download in PDF.

Step 2 – In the top paragraph, you will need to enter the patient’s name in the blank space. Below that, either the patient or their authorized health care decision maker must provide their signature in the appropriate space.

Step 3 – In the second box, the attending physician must provide their signature, the date, their printed name, their address, and their phone number.