Ontario Do Not Resuscitate Confirmation Form

Carry a copy of a DNR (Do Not Resuscitate) Confirmation Form with you if you do not wish to have CPR administered by paramedics or firefighters.

• The form must be signed by a physician, registered nurse, registered nurse in the extended class, or registered practical nurse.
• In accordance with Ontario laws, the DNR form instructs paramedics and firefighters not to administer CPR (including use of breathing tubes and resuscitation drugs).
• Palliative care (comfort care) will still be provided, including administration of oxygen, suctioning, and pain medication.
• When completed, the form will be numbered with a unique serial number.
• This form contains both English and French language versions.
• The form is issued by the Ontario Ministry of Health and Long-Term Care and the Office of the Fire Marshal.
• Available in PDF format.
• Intended to be used only in the Province of Ontario, Canada.