Printable Football Squares Free

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Printable Football Squares Free

Printable Football Squares Free

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

Free Printable Football Squares Template

Printable Football Squares FreePrint 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. Template Free Printable Football Squares 100 Printable Templates Free Free Printable Football Squares 100 Your County School Calendar Hub

Doh 3474 pdf New York State Department of Health

Blank Football Squares Printable Sheet

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 Printable Football Squares Sheets

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 Printable Football Squares Activity Shelter Printable Football Squares Template