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    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.
    Download Type: Adobe PDF
    Last Updated: 23-January-2023
    SKU: 3625