Free Do Not Resuscitate Order Form for Wyoming State Access My Form Online

Free Do Not Resuscitate Order Form for Wyoming State

A Do Not Resuscitate (DNR) Order in Wyoming is a legal document that instructs medical personnel not to perform CPR (cardiopulmonary resuscitation) on a patient if their heart stops or if they stop breathing. This form is typically filled out by individuals in consultation with their healthcare providers, focusing on those with serious illnesses or at the end of their life who choose not to have aggressive life-saving measures taken. For those considering this option, more details and the form itself can be accessed easily by clicking the button below.

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In Wyoming, individuals who wish to have control over their end-of-life medical care can use the Do Not Resuscitate (DNR) Order form, a critical tool designed to communicate their wishes regarding resuscitation attempts in the event of cardiopulmonary arrest. This form serves as a directive to medical personnel, clearly indicating that the individual does not want to undergo CPR (cardiopulmonary resuscitation) or other life-sustaining treatments that might extend their life temporarily in situations where recovery is not expected to be meaningful or align with their wishes. The preparation of a DNR form involves thoughtful consideration and often discussions with healthcare providers and family members to ensure that the document accurately reflects the person’s values and desires regarding their healthcare. It is legally recognized in Wyoming, serving as a way to respect and uphold the autonomy of individuals in their final moments, ensuring that their preferences are honored without verbal confirmation being necessary at a critical time. As such, the Wyoming Do Not Resuscitate Order form embodies a compassionate approach to end-of-life care, emphasizing personal choice and dignity.

Form Example

Wyoming Do Not Resuscitate Order

In compliance with the patient's rights and the statutes governing the state of Wyoming, this Do Not Resuscitate (DNR) Order is prepared to instruct healthcare providers concerning the administration of life-sustaining treatments. This document is crafted to respect the wishes of individuals who, in instances of severe medical conditions, opt not to undergo cardiopulmonary resuscitation (CPR) or advanced cardiac life support.

Please fill in the information requested below to ensure this order reflects the patient's preferences accurately.

Patient Information


Medical Professional Information


DNR Order Details

This section confirms the issuance of a Do Not Resuscitate Order for the above-named patient. By its provision, the patient will not receive CPR or advanced cardiac life support in the event that their breathing or heartbeat stops.




Signatures



PDF Form Details

Wyoming Do Not Resuscitate Order: Usage Instruction

Completing the Wyoming Do Not Resuscitate (DNR) Order form requires careful attention to detail and clarity in specifying the bearer's wishes regarding life-saving medical interventions. This document, once fully executed, directs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) on the individual named in the document in the event that their breathing or heart stops. It is critical that each step in the process is followed precisely to ensure the document accurately reflects the individual's decisions and is legally valid.

  1. Begin by gathering all necessary personal information, including the full legal name, date of birth, and address of the person for whom the DNR Order is being prepared.
  2. On the DNR Order form, enter the date at the top of the document where indicated. This is the date on which the form is being filled out.
  3. In the section designated for the patient's information, input the individual's full legal name, date of birth, and address in the corresponding fields.
  4. Healthcare provider information must be recorded next. Include the name, address, and telephone number of the individual's primary physician or the medical professional who is authorizing the DNR Order.
  5. There is a section on the form which requires a detailed explanation of the patient's condition and the medical rationale behind the decision to issue a DNR Order. This explanation should be clear and concise, providing sufficient medical detail for another healthcare professional to understand the basis for the order.
  6. If the form includes a space for specifying whether the DNR Order applies in all settings or only specific situations (such as only while the individual is at home), make sure this section is completed according to the person's wishes.
  7. The individual for whom the DNR Order is intended must give their consent for it to be valid. If the person is capable of making their own healthcare decisions, have them sign and date the form in the designated spots. If the individual is unable to personally consent due to medical reasons, a legally authorized representative may sign on their behalf.
  8. The healthcare professional who is authorizing the DNR Order must also sign and date the form, attesting to the medical reasons for the order and confirming that the patient or their representative has consented.
  9. Finally, check the completed form for accuracy and completeness. Make sure every required section is filled out and that there are no omissions or errors.
  10. Upon completion, ensure the DNR Order is placed in a location where it can be easily found by family members, caregivers, and emergency medical personnel. It is often recommended that a copy of the document also be given to the individual's primary care physician for inclusion in their medical records.

After the Wyoming DNR Order form has been fully completed and properly executed, it serves as an important legal document. It must be respected by healthcare professionals and loved ones, as it clearly communicates the individual's wishes regarding CPR in emergency situations. It is advisable for individuals and their families to discuss and review all medical directives regularly to ensure they continue to reflect the individual's current wishes and health status.

Important Details about Wyoming Do Not Resuscitate Order

What is a Wyoming Do Not Resuscitate (DNR) Order Form?

A Wyoming Do Not Resuscitate (DNR) Order Form is a legal document that communicates a person's wish not to receive CPR (cardiopulmonary resuscitation) or other life-saving measures if their heart stops or they stop breathing. This form is used by individuals who want their medical care to focus on comfort, avoiding aggressive life-sustaining treatments in situations where recovery is unlikely.

Who can request a DNR Order in Wyoming?

In Wyoming, a DNR order can be requested by:

  • An adult with the capacity to make their own healthcare decisions,
  • A legally appointed healthcare agent, if the individual is unable to make their own decisions,
  • The parent or legal guardian of a minor, or
  • The legal guardian of an incapacitated adult.

How can someone get a DNR Order in Wyoming?

To obtain a DNR Order in Wyoming, the individual or their authorized representative must have a discussion with a healthcare provider. This discussion will cover the implications and the scope of the decision. After agreeing to the DNR order, a healthcare provider, typically a doctor, will need to sign the form, making it an official medical order.

Is the Wyoming DNR Order valid in other states?

While many states have reciprocal recognition of DNR orders from other states, it is essential to understand that laws and regulations can vary significantly. If a person plans to travel or move to another state, they should verify the validity of their Wyoming DNR order in the new state. It may be necessary to complete a new DNR form specific to that state.

Can a DNR Order be revoked?

Yes, a DNR Order can be revoked at any time by the individual for whom it was issued. Revocation can be done in several ways, including:

  1. Telling a healthcare provider of the decision to revoke,
  2. Destroying the DNR order and any copies, or
  3. Creating a new advance directive that contradicts the DNR order.
It is crucial to communicate this change to healthcare providers, family, and, if applicable, the healthcare agent.

What should be done with the DNR Order once it is completed?

Once a DNR Order is completed and signed by a healthcare provider, it is important to:

  • Keep the original document in an easily accessible place at home,
  • Inform family members, caregivers, and healthcare agents about the DNR order and its location,
  • Provide copies to healthcare providers to include in medical records,
  • Consider carrying a copy or wearing a DNR bracelet if desired, especially when outside the home.
This ensures that in the event of a medical emergency, healthcare professionals can quickly and accurately follow the individual's wishes.

Common mistakes

When filling out the Wyoming Do Not Resuscitate (DNR) Order form, it's crucial to understand and accurately complete the document to ensure your wishes are respected. Mistakes can lead to unnecessary confusion or distress for you and your loved ones. Here are eight common mistakes that people often make when filling out this important document:

  1. Failing to sign the form - One of the most critical steps in finalizing any legal document, including the DNR order, is signing it. Without your signature, the form may not be considered valid.

  2. Not having the form witnessed as required - Depending on state requirements, a witness may need to sign the form to attest to its authenticity and your intention. Skipping this step can invalidate the document.

  3. Forgetting to date the form - Including the date on the form is not just a formality; it provides context and can be important for understanding when the directive took effect.

  4. Misunderstanding the form's purpose - Some individuals might confuse a DNR with other health directives, like a living will or a power of attorney for healthcare. Clarifying its purpose is essential for it to be effective in your intended way.

  5. Omitting relevant medical information - Accurately providing your medical information, such as allergies or current medications, is vital for healthcare providers. This omission could lead to unfavorable situations in emergencies.

  6. Not discussing the form with healthcare providers - Physicians and healthcare providers should be made aware of your DNR order. Failing to communicate your wishes can lead to them not being followed in critical moments.

  7. Using incorrect or outdated forms - States may update their DNR forms and requirements periodically. Ensure the form is the current version to comply with the latest regulations.

  8. Not updating the form - People's wishes and medical conditions can change. Regularly reviewing and updating your DNR order ensures it reflects your current desires.

While filling out a DNR order, it's advisable to consult with legal and medical professionals to ensure the document is filled out correctly and according to your state's laws. Avoiding these mistakes can provide peace of mind and ensure that your healthcare wishes are respected.

Documents used along the form

In managing health care preferences, particularly those facing serious or terminal conditions, having a Wyoming Do Not Resuscitate (DNR) order is a critical component. This legal document signals healthcare professionals not to perform CPR if a patient's breathing stops or if their heart stops beating. It's an integral part of a broader end-of-life care plan. However, a DNR is just one of many documents individuals might consider to ensure their wishes are comprehensively documented and respected. Below is an overview of additional forms and documents commonly used alongside a DNR order.

  • Advanced Healthcare Directive (Living Will): This document allows individuals to outline their preferences for medical treatment and care in situations where they are unable to communicate. It complements a DNR by covering a broader range of medical interventions beyond CPR.
  • Medical Power of Attorney (Healthcare Proxy): A crucial document that designates someone to make healthcare decisions on behalf of an individual if they become unable to make decisions for themselves. This can include decisions about life support and other treatments not covered by a DNR or living will.
  • Physician Orders for Life-Sustaining Treatment (POLST) Form: It goes a bit further than a DNR by providing a set of medical orders addressing other critical care aspects in addition to resuscitation instructions. This is particularly useful for patients with serious health conditions providing clear instructions for healthcare providers.
  • Organ and Tissue Donation Registration: An optional document that specifies an individual's wish regarding organ donation. This consent is often recorded in a registry or on a driver's license but can also be detailed in an independent document.
  • Emergency Medical Information Form: This comprehensive document includes medical history, allergies, medications, emergency contacts, and the existence of a DNR order. It is beneficial for emergency responders and medical personnel during a crisis.
  • Last Will and Testament: While not directly related to medical treatment, this legal document specifies how an individual's estate should be handled after their death. It ensures that personal matters and assets are managed according to their wishes, which can be an essential aspect of end-of-life planning.

Together, these documents provide a more complete approach to documenting an individual's end-of-life care preferences and ensuring they are respected. It's advisable for individuals to keep these documents accessible and to discuss their wishes with family members and healthcare providers to ensure that their preferences are clearly understood and followed. Consulting with a legal professional can also help to ensure that all documents are correctly drafted and legally binding.

Similar forms

The Wyoming Do Not Resuscitate (DNR) Order form is similar to several other healthcare directives in terms of its purpose and use. However, its specificity in addressing resuscitation distinguishes it from others. These documents, while varied in focus, share the common goal of providing clear instructions for healthcare professionals based on a patient's preferences. Among these, the most notable are the Living Will and the Medical Power of Attorney (POA).

Living Will: Similar to the Wyoming DNR, a Living Will is a written document that outlines a person's wishes regarding medical treatment in situations where they are unable to make decisions for themselves. Both documents serve the purpose of guiding healthcare professionals and family members during critical medical decisions. The key difference lies in their scope; while the DNR specifically addresses the desire not to have CPR or other resuscitative measures in the event of cardiac or respiratory arrest, a Living Will covers a broader range of medical interventions, including life-sustaining treatment preferences beyond resuscitation, such as mechanical ventilation and artificial nutrition.

Medical Power of Attorney (POA): Like the Wyoming DNR Order, a Medical POA allows for the designation of an individual's healthcare preferences. However, instead of focusing solely on resuscitation preferences, a Medical POA appoints another person, known as a healthcare proxy or agent, to make medical decisions on the individual's behalf if they are unable to do so themselves. This appointed agent can make decisions regarding a wide range of medical treatments and care, not just CPR or resuscitation. The alignment between the DNR and Medical POA lies in their shared goal of ensuring that medical treatment aligns with the patient's values and wishes, providing a sense of autonomy and control over one's medical care.

Dos and Don'ts

When completing the Wyoming Do Not Resuscitate (DNR) Order form, it's vital to ensure that the information provided is accurate and complies with Wyoming state laws. Below are important dos and don'ts to consider:

Do:
  1. Review the form with a healthcare professional to understand the implications of a DNR Order fully.

  2. Ensure that the person for whom the DNR is intended (or their legal representative) signs the form, indicating their understanding and consent.

  3. Fill out every required section of the form to ensure its validity. Missing information could render the document legally non-binding.

  4. Make copies of the completed DNR Order and distribute them appropriately. A copy should be easily accessible in the event of an emergency.

  5. Discuss the DNR Order with family members and loved ones to ensure they understand the individual's wishes.

  6. Consult with legal counsel if there are any questions or concerns about the effect of a DNR Order and its implications under Wyoming law.

  7. Keep the DNR Order in a visible and accessible location; first responders should be able to find it quickly in an emergency.

Don't:
  1. Leave any sections of the form blank. Incomplete forms may not be legally enforceable.

  2. Sign the form without fully understanding its consequences. The decision to not seek resuscitation in the event of cardiac or respiratory arrest is significant and irreversible once enacted.

  3. Fail to update the form if the individual’s health situation changes in a way that might affect their decision regarding resuscitation.

  4. Forget to review and possibly renew the DNR Order as required by law. Wyoming statutes may dictate a specific validity period for DNR Orders.

  5. Dismiss discussing the document with healthcare providers who need to be aware of its existence and the wishes it represents.

  6. Overlook the need for notarization or additional witnesses if required by Wyoming state law. Requirements can vary, so it's important to ensure all legal criteria are met.

  7. Assume that a DNR Order is universally recognized in all settings. Some institutions have specific forms or requirements.

Misconceptions

There are several misconceptions surrounding the Wyoming Do Not Resuscitate (DNR) Order form. Understanding these misconceptions can help individuals make informed decisions about their healthcare preferences. Here are ten common misconceptions and the truths behind them:

  1. Many people think that a Do Not Resuscitate Order is only for the elderly or those with terminal illnesses. However, the decision to have a DNR can be made by anyone at any age, based on their healthcare preferences and values.

  2. There's a misconception that once a DNR order is signed, it cannot be changed or revoked. In reality, the person who has established a DNR order can change their mind at any time and can revoke the DNR order by informing their healthcare provider.

  3. Some believe that DNR orders are universally recognized across all states. While many states have similar forms or respects the wishes contained in a DNR, specific requirements and forms, like those in Wyoming, might differ. It's important to ensure your DNR order meets the requirements of the state where you receive care.

  4. Another misconception is that a DNR order means no medical treatment will be provided. A DNR specifically addresses the use of CPR (cardiopulmonary resuscitation) and does not impact other treatments that may be used to provide comfort or address other medical needs.

  5. Some people believe that a DNR order can be established verbally by simply telling a doctor or healthcare provider. Typically, a formal, signed document is required to put a DNR order in place legally, ensuring clear communication of the patient's wishes.

  6. There is a false belief that DNR orders are only valid in hospital settings. DNR orders can also be valid in non-hospital settings, like at home or in a long-term care facility, depending on state regulations and how the DNR is documented.

  7. A common misconception is that DNR orders prevent emergency medical services (EMS) from providing any form of care. In truth, EMS can still provide many types of care and support, excluding the initiation of CPR if a DNR is present.

  8. Many think that a lawyer must draft a DNR order for it to be valid. While legal advice can be beneficial in understanding the implications of a DNR, in most states, including Wyoming, the form simply needs to be completed correctly and signed as per state requirements.

  9. Another misunderstanding is that DNR orders also apply to other life-saving measures, like intubation or artificial nutrition. DNR orders specifically address CPR and do not directly affect decisions regarding other treatments or interventions.

  10. Finally, it's falsely presumed that having a DNR order means giving up on life. Deciding to have a DNR order is a personal choice that can reflect an individual's values and desires for their end-of-life care, focusing on the quality of life rather than simply prolonging it.

It's crucial for individuals and their loved ones to understand what a DNR order entails and to communicate their healthcare wishes effectively. When considering a DNR, consulting with healthcare providers can help ensure that all parties understand the individual's desires and the implications of such orders.

Key takeaways

Navigating the complexities of healthcare decisions at the end of life can be challenging, yet critical for ensuring that an individual's wishes are respected. In Wyoming, one of the documents pivotal in this journey is the Do Not Resuscitate (DNR) Order form. This legal document speaks on behalf of individuals who wish to decline resuscitation in the event that their breathing stops or their heart ceases to beat. Here are five key takeaways to understand when filling out and using the Wyoming DNR Order form:

  • Documentation is Vital: The DNR Order must be properly documented and signed to be considered valid. This documentation is generally completed in consultation with a healthcare provider. It ensures that the individual’s wishes about not receiving cardiopulmonary resuscitation (CPR) are clearly stated and can be legally upheld.
  • Consulting with Healthcare Providers: It is essential that individuals discuss their wishes with a healthcare provider before completing a DNR Order. Healthcare providers can offer invaluable advice about the implications of DNR orders and help ensure that the form accurately reflects the individual’s wishes.
  • Form Accessibility: Once completed, the DNR Order should be readily accessible. It is advised to keep the document in a place where emergency medical services (EMS) or healthcare providers can easily find it, such as with other important medical documents or in a visible location within the home.
  • Legal Recognition: Wyoming recognizes DNR Orders as legally binding documents. This means that healthcare professionals are legally obligated to respect the wishes documented in the form, as long as it is presented and appears valid and consistent with Wyoming laws.
  • Periodic Review and Updates: It is prudent to review and, if necessary, update the DNR Order periodically. As individuals’ health conditions or perspectives on end-oflife care may change, reviewing the order ensures that it continues to reflect their current wishes. Any changes to the document should be discussed with a healthcare provider and properly documented.

In conclusion, the Wyoming DNR Order is an essential document for those wishing to have control over their end-of-life medical care. By ensuring it is correctly completed, accessible, and periodically reviewed, individuals can have peace of mind knowing their healthcare wishes will be respected.

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Fact Detail
Purpose A Wyoming Do Not Resuscitate (DNR) Order form is designed to tell health care providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating.
Applicable Law The Wyoming DNR Order is governed by Wyoming statutes. Title 35 of the Wyoming Statutes, Public Health and Safety, contains provisions that guide the creation and use of DNR orders in the state.