How to Get a DNR in California: Form, Physician, and POLST

To get a Do Not Resuscitate order in California, you complete the state’s official Emergency Medical Services Prehospital DNR form with your physician, who signs it alongside you. That single form, properly filled out and kept somewhere paramedics can find it, is what makes the order legally effective. The framework sits in California Probate Code Sections 4780 through 4786, and the form itself was developed by the Emergency Medical Services Authority (EMSA) with the California Medical Association.

Who Can Request One

Any California adult with decision-making capacity can request a DNR. Under Probate Code Section 4609, capacity means you can understand the nature and consequences of a healthcare decision, weigh the benefits, risks, and alternatives, and communicate your choice.¹ You do not need to be terminally ill, and there is no age requirement beyond being a legal adult.

If you lack capacity, someone with legal authority to make your healthcare decisions can request it for you. That may be an agent under a durable power of attorney for healthcare, a court-appointed conservator, or another surrogate recognized under California law.² The signing physician has to confirm that authority before completing the order.

Get the Official Form

The document you need is the Emergency Medical Services Prehospital Do Not Resuscitate Form, sometimes called the EMSA/CMA form. Order copies from the California Medical Association publications office at 1-800-882-1262 or through the CMA online store.³ Most physicians’ offices keep copies on hand as well, so ask before ordering your own.

A generic DNR document pulled from the internet will not work here. California EMS personnel are trained to look for this specific state-approved form, and anything else will be treated as invalid at the scene.

Fill It Out With Your Physician

The form asks for your full legal name, your physician’s name, the physician’s California medical license number, and contact information.⁴ Two signatures are needed: yours (or your authorized decision-maker’s) and your physician’s. The physician’s signature confirms you gave informed consent to the DNR instruction.³ No witness or notary is required.²

One detail trips people up: only a physician can sign the DNR form. Nurse practitioners and physician assistants cannot, even though they can co-sign a POLST.³ If the license number is missing, the physician’s signature is missing, or the form has been altered, emergency responders will treat it as invalid and start full resuscitation.

Consider a Medallion or Bracelet

California law lets you evidence a DNR with a medallion or bracelet engraved with “do not resuscitate” or “DNR.”⁵ It is a backup for when the paper form is not within reach, and paramedics are trained to check the wrist and neck before beginning invasive procedures.²

Only medallions from vendors approved by EMSA are recognized. A standard medical alert bracelet from an unapproved source may not be honored. The current approved vendors are StickyJ Medical ID, MedicAlert Foundation, Caring Advocates, and Empower Hope, Inc., with contact information posted on the EMSA website.³ The engraved details should match what appears on your signed form.

Keep It Where Paramedics Will Find It

A signed DNR does nothing in a filing cabinet. California EMS personnel are trained to look in specific spots when they enter a home: the front of the refrigerator and the area near the patient’s bedside. Posting the original form in one of those places is standard practice.

Beyond the copy at home, take these steps so the order is actually accessible:

Give a copy to your physician’s office so it goes into your permanent medical record and can be pulled if you are admitted to a hospital.
Tell family members and caregivers where the form is and what it says. A relative who hides the form or contradicts it in the moment can create real problems for responders.
Wear an approved medallion or bracelet when you are away from home.

When EMS arrives, they will verify the form before honoring it. A missing, damaged, or altered form sends them straight to full resuscitation, which is the opposite of what a properly stored DNR is meant to accomplish.

What the DNR Covers, and What It Does Not

A California prehospital DNR tells emergency personnel to withhold chest compressions, assisted ventilation, intubation, defibrillation, and heart-stimulating drugs if you go into cardiac or respiratory arrest.³ That is the whole scope. It applies only when your heart or breathing has stopped.

It does not stop paramedics from treating pain, difficulty breathing, major bleeding, or any other emergency where you still have a pulse and are breathing. It does not address artificial nutrition, hydration, or other life-sustaining measures outside resuscitation.³ A DNR is not a “do nothing” order. EMS will still provide comfort care and treat what can be treated.

DNR or POLST

California also recognizes the Physician Orders for Life-Sustaining Treatment (POLST) form, and it is not interchangeable with the DNR. The DNR answers one question: whether to attempt CPR when your heart or breathing stops. The POLST covers that same question and adds direction on the level of medical intervention you want when you still have a pulse, along with decisions about artificial nutrition.³

If your only concern is declining CPR, the prehospital DNR is enough. If you want to spell out broader preferences, whether that means limited interventions, comfort-focused care, or feeding-tube choices, the POLST fits better. The POLST can be signed by a nurse practitioner or physician assistant working under physician supervision, while the DNR still requires a physician.³ Both are valid statewide as medical orders.⁵ Many people also keep a broader advance healthcare directive that names a healthcare agent and sets out wishes for situations beyond emergency response.

Changing Your Mind

You can revoke a DNR at any time if you have capacity. Probate Code Section 4695 allows revocation “at any time and in any manner that communicates an intent to revoke.”⁶ Destroying the form, telling your physician verbally, or crossing it out all count. The same standard applies to a POLST.⁵

If you are conscious and able to speak during an emergency, your words override the form. Paramedics who hear you ask for help will resuscitate. After revoking, follow through on the paperwork: notify your physician, collect and destroy every copy, return or dispose of any medallion, and tell your family and caregivers the order no longer stands. A stale form still stuck to the refrigerator can undo a revocation at the worst possible moment.

1
California Legislative Information. California Probate Code 4609
2
California Emergency Medical Services Authority. Do Not Resuscitate (DNR) and Other Patient-Designated Directives: EMS Personnel Guidelines
3
California Emergency Medical Services Authority. DNR and POLST Forms
4
California Emergency Medical Services Authority. Emergency Medical Services Prehospital Do Not Resuscitate (DNR) Form
5
California Legislative Information. California Probate Code 4780
6
California Legislative Information. California Probate Code 4695 – Revocation of Advance Directives