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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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12600hPrint 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. Buy GEEKOMMini PC Mini IT13 13th Intel Core I5 13500H 12C 16T Up To Minisforum MS 01 Work Station

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 Gigabyte AORUS 9KF G3ES513SH Port til 17 3 I7 12600H 16GB RTX 4060

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 SZ711 Series Compact Fanless IPC Saintwaytech Minisforum MS 01 Intel Core I9 13900H Core I9 12900H I5 12450H

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