In order to receive the care you would prefer in a life threatening medical emergency, it is recommended that you make medical decisions before you are impaired by illness or injury. The following forms will help guide you, your family and decisions of your physician should you be unable to make decisions on your own. Download, print and complete each form, and be sure to share with your family.
Do Not Resuscitate (DNR) Form (Download)
The Do Not Resuscitate Form instructs health care providers not to do cardiopulmonary resuscitation (CPR) if breathing stops or if the heart stops beating. A DNR order allows you to choose before an emergency occurs whether you want CPR.
Living Will Directive and Health Care Surrogate Designation (Download)
The Living Will form should be used to let your physician and your family know what kind of life-sustaining treatments you wish to receive if you become terminally ill, permanently unconscious or are unable to make decisions on your own free will. This form should also be used if you would like to designate someone to make healthcare decisions on your behalf should you become unable to convey your wishes.
Medical Orders Scope of Treatment (MOST) Form (Download)
The MOST form is a brief, simple, highly visible, portable medical order that quickly translates end of life care goals into preferred treatments. It is an additional tool to ensure that your preferences are known and honored.
Fight health care fraud: guard your Medicare number! The next Medicare Open Enrollment season (October 15 to December 7) is almost here, which means fraudsters and identity thieves will increase their efforts to get and abuse Medicare numbers from people like you. Fortunately, there are many measures you can take to fight health care fraud.
Jefferson County Recovery Resources (Link)