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Virginia Do Not Resuscitate (DNR) Order Form

The Virginia do not resuscitate (DNR) order form is a statement that informs medical personnel that a patient does not want to receive CPR or other lifesaving treatments in the event of respiratory or cardiac arrest. The order must be issued to the patient by a licensed physician who has established a relationship with the individual.
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  • Laws – § 54.1-2987.1
  • Required to Sign – Patient (or representative) and physician.

Sample