Virginia Do Not Resuscitate (DNR) Order FormVirginia Do Not Resuscitate (DNR) Order FormVirginia Do Not Resuscitate (DNR) Order Form
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Authorized Durable Do Not Resuscitate Order Form & Instructions
Purpose
The Durable Do Not Resuscitate (DDNR) Order and its regulations have been developed to carry out the intent
of applicable Virginia law that provides a person the opportunity to execute a DDNR Order that comports with
his/her wishes.
Applicability
The DDNR form may be honored by any "qualified health care personnel," which is defined as any qualified
emergency medical services personnel and any licensed healthcare provider or practitioner functioning in any
facility, program or organization operated or licensed by the State Board of Health, or by the Department of
Mental Health, Mental Retardation and Substance Abuse Services or operated, licensed or owned by another
state agency, or a licensed health care practitioner at any continuing care retirement community.
Instructions
12VAC5-66-70. Issuance of a Durable DNR Order Form or Other DNR Order.
A Durable DNR Order Form or Other DNR Order may be issued to a patient