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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DOH-3474
for the current year.
Form DOH-3474 Nonhospital Order Not to Resuscitate (DNR Order) - New York
What Is Form DOH-3474?
This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DOH-3474?
A: Form DOH-3474 is a Nonhospital Order Not to Resuscitate (DNR Order).
Q: What does DNR stand for?
A: DNR stands for Do Not Resuscitate.
Q: Who can complete Form DOH-3474?
A: The patient, or their designated Health Care Proxy or agent, can complete Form DOH-3474.
Q: What does Form DOH-3474 allow?
A: Form DOH-3474 allows individuals to specify their preference to not be resuscitated in the event of a cardiac or respiratory arrest.
Q: Is Form DOH-3474 legally binding?
A: Yes, Form DOH-3474 is a legally binding document in New York.
Q: Is Form DOH-3474 valid in other states?
A: No, Form DOH-3474 is specific to New York state and may not be valid in other states.
Q: Can a health care provider refuse to honor Form DOH-3474?
A: A health care provider can only refuse to honor Form DOH-3474 if it conflicts with their ethical or religious beliefs.
Form Details:
- Released on December 1, 2018;
- The latest edition provided by the New York State Department of Health;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form DOH-3474 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.
