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The Arizona Prehospital Medical Care Directive, also referred to as a DNR (do not resuscitate) order, registers an individual’s choice not to be resuscitated in cases where they cease to breathe or go into cardiac arrest. For the express action to be recorded, a doctor must explain the ins & outs of the document and provide their signature confirming that they informed the patient.
To activate the policy within the form, the principal must supply either a recent picture of themselves or their personal details within the document and then sign it with the assistance of a notary public. If you cannot use a notary public, you may have an eligible witness observe the endorsement and sign off on the document as acknowledgment. (If the principal is already incapacitated, then their attorney-in-fact may complete the form if a previous health care power of attorney was accomplished.)
Laws
Definitions – § 36-3251
Signing Requirements – The individual issuing powers to an agent must sign while being observed by a witness or notary public (§ 36-3221(3)).
Additional Resources
- Arizona Dept. of Economic Security – Decisions About Your Health Care Guide
- Arizona Hospital and Healthcare Association – Arizona POLST
- Health Current – Arizona Healthcare Directives Registry
Related Forms (4)
- Advance Directive
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- Health Care Directive Registration Agreement
Download: Adobe PDF
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF
Health Care Directive Registration Agreement
Download: Adobe PDF
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