Free Arizona Prehospital Medical Care Directive Form | PDF

Arizona Prehospital Medical Care Directive Form

Last updated June 2nd, 2024

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The Arizona Prehospital Medical Care Directive, also referred to as a DNR (do not resuscitate) order, registers an individual’s choice not to be resuscitated in cases where they cease to breathe or go into cardiac arrest. For the express action to be recorded, a doctor must explain the ins & outs of the document and provide their signature confirming that they informed the patient.

To activate the policy within the form, the principal must supply either a recent picture of themselves or their personal details within the document and then sign it with the assistance of a notary public. If you cannot use a notary public, you may have an eligible witness observe the endorsement and sign off on the document as acknowledgment. (If the principal is already incapacitated, then their attorney-in-fact may complete the form if a previous health care power of attorney was accomplished.)

Additional Resources

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Health Care Directive Registration Agreement

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