Illinois DNR Form: How It Works, Who Signs It, and How It Differs From a POLST

A hospice patient's family finds a handwritten note taped to the refrigerator: "Do not resuscitate." When paramedics arrive for a cardiac emergency, they begin CPR immediately. The note has no legal standing — in Illinois, a DNR must be a signed medical order from a qualified healthcare practitioner, not a personal instruction.

This distinction between a personal wish and a medical order is the entire purpose of the Illinois DNR form.

What the Illinois DNR Covers (and What It Does Not)

The IDPH Uniform Do-Not-Resuscitate form is a clinical order with exactly one function: it instructs healthcare personnel not to initiate cardiopulmonary resuscitation (CPR) if the patient's heart stops beating or they stop breathing.

That scope is deliberately narrow. The DNR says nothing about:

• Mechanical ventilation or intubation
• IV antibiotics, fluids, or medications
• Transfer to a hospital or ICU
• Feeding tubes or artificially administered nutrition
• Comfort care measures like pain management

A patient with a DNR can still receive aggressive treatment for a treatable condition. If you have a DNR and develop pneumonia, the medical team will still treat the pneumonia with antibiotics and supportive care. The DNR only applies to the specific scenario of cardiac or respiratory arrest.

This narrow scope is why hospice nurses and palliative care teams often recommend a POLST form alongside or instead of a standalone DNR. The POLST covers the full spectrum of life-sustaining treatment decisions — CPR, ventilation, scope of treatment, and nutrition — in a single physician-signed order. If the patient's preferences extend beyond just "no CPR," the POLST is the more comprehensive document.

Who Must Sign the DNR

The DNR is a medical order, not a personal legal document. This means a patient cannot simply write and sign one independently. The signature requirements are:

The qualified healthcare practitioner (QHCP): In Illinois, this includes a licensed physician, an advanced practice registered nurse, a physician assistant, or a medical resident in their second year or higher. The QHCP signs the order section of the form after discussing the patient's condition and prognosis.

The patient or legally authorized representative: The patient signs the consent section. If the patient cannot sign (due to physical incapacity or a medical emergency), verbal or telephonic consent is legally acceptable under Illinois administrative guidance — but the facility staff must document the consent method directly on the form.

A formal witness is not required for the patient consent section of the DNR, which differs from the healthcare POA (one witness required) and the living will (two witnesses required).

Requesting a DNR: The Conversation

A DNR is not something your physician initiates unprompted. In practice, the conversation starts in one of these contexts:

• Hospice enrollment: The hospice intake team will discuss resuscitation preferences as part of the plan of care
• Nursing home admission: Long-term care facilities typically ask about DNR preferences during the intake assessment
• Hospital stay for serious illness: The attending physician may raise the topic during goals-of-care discussions for a patient with a poor prognosis
• Patient or family request: You or your healthcare agent can ask your physician to write a DNR at any time

If your physician believes a DNR is not medically appropriate, they can decline to sign the order. You can request a second opinion or transfer care to a physician willing to honor your wishes.

Where to Keep the DNR for Emergency Access

The DNR is only useful if emergency responders can find it immediately. The Illinois standard is:

• Original form on the refrigerator — clipped or taped at eye level. Paramedics in Illinois are trained to check the refrigerator door first when looking for medical orders in a home setting
• Copy in your medical chart at the nursing home, hospice, or hospital
• Copy with your healthcare agent so they can present it to any new facility or responding EMS team
• Copy in your patient portal (Epic MyChart or equivalent) for electronic access

Do not store the only copy in a safe, locked drawer, or bank safe deposit box. If paramedics arrive and cannot locate the form within seconds, they are legally required to begin CPR.

For patients who have both a DNR and a POLST, keep both forms together. The POLST is the broader document and will typically be the first one reviewed by medical staff, but having the standalone DNR provides additional clarity on the CPR-specific instruction.

Revoking a DNR

A patient with decision-making capacity can revoke a DNR at any time by:

• Telling their physician to cancel the order
• Physically destroying the form
• Requesting that the form be removed from the medical record

A healthcare agent can also request revocation if the patient no longer has capacity. The physician must then write new orders reflecting the patient's or agent's updated instructions.

How the DNR Fits Into Your Advance Planning

The DNR is one piece of a larger system. The healthcare power of attorney appoints your decision-maker. The living will documents your preferences for terminal situations. The POLST translates those preferences into comprehensive medical orders. And the DNR provides a focused, unmistakable instruction about CPR.

For most patients with serious illness, the POLST supersedes the standalone DNR because it covers CPR plus all other life-sustaining interventions. The standalone DNR remains useful for patients who want a narrow, single-issue order without addressing ventilation, nutrition, or scope of treatment.

The Illinois Advance Directive & Living Will Kit explains how these documents interact and helps you determine which combination is right for your medical situation — so nothing falls through the gaps when a crisis arrives.

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