The South Carolina do not resuscitate (DNR) order form is a notice informing emergency medical service providers that no resuscitative measures shall be administered to a patient in the event they experience cardiopulmonary arrest. A DNR order may be requested by the patient or from a representative authorized to make medical decisions on their behalf (i.e., surrogate or agent). Furthermore, the order may only be executed if a physician has determined that the patient suffers from a terminal condition.
South Carolina is developing the Physician Orders for Scope of Treatment (POST) program which enables patients to better outline their end-of-life health care decisions. Currently, the program is only available in Charleston and Greenville. Click here to learn more about the POST program.
Laws – § 44-78-10 – § 44-78-65
Required to Sign – Physician, and patient (or surrogate/agent).
How to Write
Step 1 – Download the South Carolina DNR form in Adobe PDF.
Step 2 – Enter the patient’s name in the first available space.
Step 3 – Enter the following information in the spaces below the “REVOCATION PROCEDURE” heading:
- Date of execution
- Physician’s name
- Physician’s address
- Signature of patient/surrogate/agent
- Physician’s signature
- Physician’s telephone number
