To complete a Maine Comfort Care/DNR form, download the correct version from the Maine EMS website, fill it out with your healthcare provider, and sign it together. The form is a pre-hospital medical order telling emergency responders not to perform CPR if your heart stops or you stop breathing. No attorney is needed, and the form is free.
Pick the Right Form First
Maine’s program has two forms, and they are not interchangeable. The one you use depends on whether the patient can make their own medical decisions at the time of signing.1Maine Emergency Medical Services. Comfort Care/Do Not Resuscitate
- The CC/DNR Directive is for a patient who has the mental capacity to make an informed decision. You sign it yourself, with your clinician.
- The CC/DNR Order is for a patient who lacks that capacity. An authorized decision-maker (a healthcare agent, legal guardian, or other person recognized under Maine law) signs on the patient’s behalf, and only a licensed physician (MD or DO) can sign as the clinician.
Both forms are available for free download from the Maine EMS Comfort Care/DNR Program page.2Maine Emergency Medical Services. Comfort Care/DNR Program Your provider’s office may also have printed copies.
Completing the CC/DNR Directive
The Directive is the common form, used when the patient is making the decision for themselves. It takes two signatures: yours and your clinician’s.
What You Fill In
Print your full name at the top. If you want the directive to lapse automatically after a certain date, write that date in the optional expiration field; leaving it blank means the directive stays in effect until you revoke it. Then sign and date.3Maine Emergency Medical Services. Maine EMS Comfort Care/Do Not Resuscitate Program Physician Instructions
What Your Clinician Does
Before signing, your provider has to be satisfied that you understand the risks, burdens, and benefits of refusing resuscitation given your condition, and that your decision is informed. The clinician then signs the form, agreeing to comply with your decision and to direct other providers under their authority to do the same. A licensed physician, nurse practitioner, or physician assistant can sign the Directive.3Maine Emergency Medical Services. Maine EMS Comfort Care/Do Not Resuscitate Program Physician Instructions
Both signatures are required. A form missing either one is not valid, and EMS crews will not follow it.
Completing the CC/DNR Order
When the patient cannot make their own decision, the Order form shifts the signatures to the attending physician and the authorized decision-maker.
The attending physician fills in the patient’s full name on the front. The authorized decision-maker (someone holding a healthcare power of attorney, a court-appointed guardian, or another party recognized under Maine law) signs in the designated section. The physician then signs, dates the form, prints their name legibly, and provides an emergency contact number. Only a licensed MD or DO can sign the Order; nurse practitioners and physician assistants cannot.3Maine Emergency Medical Services. Maine EMS Comfort Care/Do Not Resuscitate Program Physician Instructions
Printing and Posting
Print the form on standard letter-size white paper, as the official physician instructions specify.3Maine Emergency Medical Services. Maine EMS Comfort Care/Do Not Resuscitate Program Physician Instructions Then put it somewhere EMS crews will see it the moment they walk in: on the refrigerator, taped near the front door, or posted by the bed. Responders are trained to look for the form, but they cannot honor what they cannot find. If you split time between homes, keep a signed copy at each.
Portable Identification for When You Leave Home
The paper form stays at the house. For everywhere else, Maine’s program recognizes several portable identifiers.
Maine EMS-Approved DNR Jewelry
You can obtain Maine EMS-approved Comfort Care/DNR jewelry — a bracelet or medallion — that responders will honor in place of the paper form. The jewelry must display your name clearly and indicate your DNR status.4Maine.gov. Maine EMS Comfort Care/DNR Guidelines It also has to be approved by Maine EMS; generic medical alert jewelry that simply says “DNR” without meeting the state’s standards may not be recognized. Your provider or the Maine EMS program page can direct you to approved vendors.
Wallet Cards and Plastic Bracelets
The CC/DNR Order form also references a wallet card and a plastic bracelet as additional ways to communicate your status.5Maine Emergency Medical Services. Maine EMS Comfort Care/Do-Not-Resuscitate When responders arrive, they document which identifier they relied on to confirm your Comfort Care/DNR status.4Maine.gov. Maine EMS Comfort Care/DNR Guidelines Carrying at least one portable identifier whenever you leave home is the single most practical step after completing the form.
How to Revoke the Form
You can cancel your Comfort Care/DNR status at any time, for any reason, with no advance notice.
If you signed a Directive yourself, revoke it by destroying the form and any DNR jewelry, or by verbally telling EMS personnel on the scene that you want to be resuscitated.4Maine.gov. Maine EMS Comfort Care/DNR Guidelines If you clearly state you want CPR, responders will disregard the prior directive and provide full resuscitation. Your current spoken wishes override the written document.
An Order form can be revoked by the patient, by the physician, PA, or NP who signed it, or by the authorized decision-maker who signed on the patient’s behalf. Revocation means destroying the Order form, wallet card, plastic bracelet, and DNR jewelry (whichever are in use) or verbally withdrawing the order.6Maine ACEP. Medical Director Guidebook Family members who were not designated as the healthcare agent or authorized decision-maker do not have authority to revoke the Order during an emergency; the crew will honor the document as written.
Physically tearing or cutting the form is the clearest way to prevent later confusion.
It’s Not the Same as a Living Will
A living will or advance health care directive is a broader document covering end-of-life treatment preferences like feeding tubes, mechanical ventilation, and pain management, and it goes into effect when you become incapacitated and cannot communicate. The Comfort Care/DNR form addresses one specific scenario: cardiac or respiratory arrest.
The practical difference is who honors it. EMS crews generally cannot act on a living will or a medical power of attorney at the scene; those documents are designed for hospitals, nursing facilities, and longer-term care settings. The Comfort Care/DNR form is formatted as a pre-hospital medical order that field responders are authorized and trained to follow immediately. Having a living will does not eliminate the need for a separate Comfort Care/DNR form if you want responders to withhold CPR.
If You Have an Out-of-State DNR
If you hold a valid DNR order from another state and are traveling through or relocating to Maine, EMS personnel can honor that document if it substantially reflects the intent of a Maine Comfort Care/DNR directive. Responders look for clear evidence that a physician issued the order and that the patient or their representative consented. The format does not need to match Maine’s form exactly, but it should be recognizable as a physician’s order rather than a general advance directive.
Many states use a POLST or MOLST form that functions similarly to Maine’s Comfort Care/DNR, and these portable medical orders are generally treated as equivalent by crews encountering them. If you are moving to Maine permanently, completing a Maine-specific form with a local provider removes any question about validity.