A Cardiopulmonary Resuscitation (CPR) Directive is a legal document in which you state a choice to not have CPR or other methods of restarting your heart and breathing in the event your heart stops. A CPR Directive is often called a Do Not Resuscitate (DNR). To complete a CPR Directive you will need to talk to your doctor as their signature is required for the document to be valid. A CPR Directive may be issued independently or as part of the Medical Orders for Scope of Treatment (MOST) form. It is recommended to keep a copy at all times, as Emergency Medical Technician (EMT) or other emergency personnel may not be adequately informed of an individual’s intentions. There are bracelets and pendants that you can wear to indicate you have a CPR Directive. The CPR does not need to be notarized.
Information Needed
Before you start completing a CPR Directive, ensure you have the following information available.
About the Patient
Full Name
Date of Birth
Gender
Hair and Eye Color(s)
Race/Ethnicity
The Patient's Preferences
Instruction concerning the administration of CPR
Tissue donation information (optional)
About the Signing Doctor
Full Name and Address
Telephone Number
Colorado Medical License Number
If the Patient is in Hospice
Name of the hospice program/provider
Best Practices
To make sure that you get the most benefit from a CPR Directive, follow these tips from our experts.
The form needs to be completed by both the patient and their doctor.
The form need to be signed by the doctor to be valid.
Discuss your preference with your agent, alternates, doctor, religious leader, or any other person in your life that is part of your support circle.
Wear a pendant or necklace indicating you have a CPR directive (optional).
Who to Notify
To ensure that your wishes are followed and the CPR Directive is acknowledged, make sure you give copies to the following individuals.
Give Copies of Form to:
Doctor
Agent (if appointed by MDPOA)
Alternate agents, if any
Download a CPR Directive
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