At Speedy Template, You can download Florida Do Not Resuscitate Form . There are a few ways to find the forms or templates you need. You can choose forms in your state, use search feature to find the related forms. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.
The Florida do not resuscitate form is provided by Florida Department of Health.
State of Florida
DO NOT RESUSCITATE ORDER
(please use ink)
Patient’s Full Legal Name:________________________________________________Date:____________________
(Print or Type Name)
PATIENT’S STATEMENT
Based upon informed consent,I,the undersigned,hereby direct that CPR be withheld or withdrawn.
(If not signed by patient,check applicable box):
qSurrogateqProxy (both as defined in Chapter 765,F.S.)
qCourt appointed guardianqDurable power of attorney (pursuant to Chapter 709,F.S.)