NJ DNR Form: How to Get a Do Not Resuscitate Order for Home Use

A living will sitting in a drawer will not stop a paramedic from performing CPR. New Jersey emergency medical services are legally required to attempt full resuscitation unless they can see a valid, physician-signed DNR order at the scene. If the form is not visible, they default to aggressive intervention — chest compressions, intubation, defibrillation — regardless of what your advance directive says.

For terminally ill patients who want to die peacefully at home, the out-of-hospital DNR form is essential.

What the Out-of-Hospital DNR Order Is

A Do Not Resuscitate order is a specific clinical directive instructing healthcare providers not to attempt CPR if you experience cardiac or respiratory arrest. For home settings, New Jersey uses a dedicated, state-approved out-of-hospital DNR form that is recognized by all EMS providers statewide.

This is a medical order — not a patient declaration. It carries the same legal weight as a prescription or a hospital DNR order, and EMS must comply with it.

Who Signs the Form

The out-of-hospital DNR requires two signatures:

1. The attending physician or Advanced Practice Nurse (APN) — their signature is what makes this a binding medical order
2. The patient or their legal surrogate — confirming the decision to decline resuscitation

You cannot complete a DNR form on your own. Start the conversation with your primary care physician, oncologist, or hospice provider. If you are already receiving hospice care, the hospice medical director typically initiates this.

Where to Display the DNR at Home

The entire point of an out-of-hospital DNR is immediate visibility. First responders need to find it within seconds of arriving at your home. Standard placement:

• Refrigerator door — the first place most EMS teams look
• Bedroom door or headboard — for patients who are bedbound
• On the patient's person — via an official Medical Society of New Jersey (MSNJ) approved DNR wrist or ankle bracelet

The MSNJ bracelet is particularly important for patients who may experience a medical emergency outside the home — at a store, a family member's house, or in a vehicle. Without the bracelet or a visible form, EMS will attempt resuscitation even if the patient's family verbally objects.

DNR vs. POLST — Which Do You Need?

If your physician completes a POLST (Practitioner Orders for Life-Sustaining Treatment) form with a DNAR order in Section A, the POLST completely replaces a separate out-of-hospital DNR. You do not need both.

The POLST is the more comprehensive document because it covers not just CPR but also the level of medical intervention (full, limited, or comfort only) and artificial nutrition. Most clinicians now recommend completing a POLST rather than a standalone DNR because it addresses more clinical scenarios.

However, if your physician is only willing to sign a DNR order and not a full POLST, the standalone out-of-hospital DNR form is still valid and enforceable.

DNR Does Not Mean "Do Not Treat"

A common and dangerous misconception: a DNR order only applies to cardiopulmonary resuscitation. It does not restrict any other medical treatment. EMS will still treat pain, administer oxygen, manage symptoms, and transport you to a hospital if needed. A DNR patient who falls and breaks a hip still receives full emergency care for the fracture — they just will not receive CPR if their heart stops during treatment.

What Happens If the DNR Is Not Visible

If EMS arrives and cannot locate a valid DNR form or MSNJ bracelet, they are legally obligated to begin full resuscitation. A family member's verbal request to stop is not sufficient. By the time someone retrieves the form from a filing cabinet or calls the doctor's office, resuscitation is already underway — and stopping it once started creates a different set of medical and legal complications.

This is why placement matters more than paperwork.

The New Jersey Advance Directive & Living Will Kit includes a POLST and DNR coordination guide that ensures your advance directive, POLST, and DNR all align — preventing the conflicting-document problem that causes clinical confusion during the exact moments when clarity matters most.

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