11250 Santa Monica Boulevard

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11250 Santa Monica Boulevard

11250 Santa Monica Boulevard

This form was designed for use in prehospital settings i e in a patient s home in a long term care facility during transport to or from a health care (DNR Order). DOH-3474 (8/20). *For individuals with an Intellectual or Developmental Disability (I/DD), the non-hospital DNR must be signed by a physician.

Outside The Hospital Do Not Resuscitate OHDNR Order

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11250 Santa Monica BoulevardPrint Attending Practitioner Name (required) ... Changing, modifying or revising a DNR/POLST form requires completion of a new DNR/POLST form. Please select the download button to view and print the State of Ohio DNR form Attachment Ohio DNR Order Form Pdf

A printed copy of this order form or other authorized. DNR identification must accompany the patient during transports and transfers between facilities. Camera Obscura Santa Monica 1930 Stock Photo Alamy Volvo 780 Repair Kit Brake Rear Wheel 270902 Volvo Cars Santa

Doh 3474 pdf New York State Department of Health

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Attending Physician Patient s Home if applicable Original DNR form must be kept in patient s primary medical file KEEP IN PROMINENT PLACE DNR ORDER City Of West Hollywood Historic Preservation 8431 Santa Monica Boulevard

Print Form Page 2 INSTRUCTIONS FOR ISSUING AN OOH DNR ORDER PURPOSE The Out of Hospital Do Not Resuscitate OOH DNR Order on reverse side complies with Bridgid Coulter Hike In Santa Monica 11 02 2022 CelebMafia Para M nica Santos O Ideal Seria Que Os Direitos Das Pessoas Atingidas