South Carolina Do Not Resuscitate Form Requirements

The South Carolina Do Not Resuscitate form is officially designated DPH 3462, and you can download it from the South Carolina Department of Public Health’s EMS forms page or get a copy from your physician’s office.¹ It becomes legally valid once a physician who has diagnosed a terminal condition signs it along with the patient (or an authorized decision-maker). No witnesses or notary are required.²

You may still see the form referred to as “DHEC 3462” in older materials. When South Carolina reorganized the Department of Health and Environmental Control on July 1, 2024, its public health functions moved to the new Department of Public Health, and the form was renamed accordingly.³ It is the same document.

Who Qualifies

The threshold requirement is a terminal condition. South Carolina law defines that as an incurable or irreversible condition that, in reasonable medical judgment, will cause death within a reasonably short period whether or not life-sustaining treatment is provided.² A physician must make that diagnosis and document the date, time, and supporting medical facts in the patient’s record.

The statute limits the signing “health care provider” to someone licensed to practice medicine or osteopathy. A nurse practitioner or physician assistant cannot substitute for the physician’s signature on this form.²

Adults

An adult with the mental capacity to make medical decisions can request the order and sign it directly. If the patient is incapacitated, the request can be made by a surrogate under South Carolina’s Adult Health Care Consent Act or by an agent named in a healthcare power of attorney.²

Children

A 2022 amendment extended DNR orders to children, defined as anyone under eighteen who is not married or judicially emancipated and who is medically eligible for hospice care because of a terminal condition.² A child cannot request the order on their own; only a parent or legal guardian with medical decision-making authority can.

Before the order can be signed for a child, the requesting parent or guardian must make a reasonable attempt to notify the other parent or guardian, orally or in writing. If there is no response within forty-eight hours, the process moves forward. The physician documents the notification attempt, including the date, time, and method, in the child’s medical record.⁴

Completing the Form

DPH 3462 reads as a notice to EMS personnel. It identifies the patient, confirms the terminal diagnosis, and directs that no resuscitative treatment be provided in the event of cardiac or respiratory arrest. To be valid, it needs:

The patient’s signature, or the signature of a surrogate, healthcare agent, parent, or legal guardian if the patient cannot sign
The signature of the physician who diagnosed the terminal condition
The physician’s address and telephone number
The date the order was completed

Witnesses and notarization are not required. “Resuscitative treatment” for purposes of this order means artificial stimulation of the heart and lungs by electrical, mechanical, or manual means, including CPR, chest compressions, defibrillation, breathing tubes, and cardiac drugs. EMS must still provide palliative care to keep the patient comfortable.2

Where to Keep the Signed Form

Once signed, the original needs to be somewhere paramedics can find it quickly. Many people tape it to the refrigerator or keep it on a nightstand near the bed. Filing it away in a drawer or a cabinet defeats the purpose of the document, since EMS follows the order only when they can actually see it on arrival. Give copies to family members and to any healthcare providers involved in ongoing care.

The DNR Bracelet Alternative

South Carolina also recognizes a DNR bracelet that carries the same legal weight as the paper form. The bracelet must show an internationally recognized medical symbol on the front and the words “South Carolina Do Not Resuscitate EMS” along with the patient’s first and last name on the back.²

You cannot buy one directly. The bracelet must come from a commercial vendor approved by the Department of Public Health, and the vendor will not fulfill the order without a physician’s order for it. The physician either affixes the bracelet or provides an order form for the patient to submit. The patient, or the parent or guardian for a child, pays the cost.² When EMS sees a valid, unaltered bracelet, they honor it just as they would the paper form.

What This Form Does Not Cover

DPH 3462 is a narrow document. It governs out-of-hospital emergencies and directs EMS personnel, first responders, and state-certified emergency medical technicians. If the patient is already admitted to a hospital, a separate in-hospital DNR order runs through the treating physician and hospital protocols.

The order also addresses one clinical situation: whether to attempt to restart the heart or breathing. It says nothing about feeding tubes, ventilators in a hospital setting, antibiotics, or other treatments. Those preferences belong in a living will, and decisions about who speaks for you if you cannot speak for yourself belong in a healthcare power of attorney. Both are governed by separate South Carolina statutes, and having a DNR does not replace either one. Many people with a terminal condition end up with all three documents.

Some states use a Physician Orders for Life-Sustaining Treatment (POLST) form that addresses hospital transfers, intubation, antibiotics, and feeding tubes. South Carolina’s EMS DNR form does not cover that broader range. The statute also states that honoring a DNR does not constitute suicide for any legal purpose, and nothing in the law authorizes mercy killing or euthanasia.²

Changing Your Mind

A DNR order can be revoked at any time, by the patient or by the parent or legal guardian of a child, and no paperwork is needed to do it. Any of the following revokes the order:²

Telling EMS, a first responder, or emergency facility staff that you want to be resuscitated. Once you say this, they must disregard the DNR and promptly remove any bracelet.
Tearing, marking over, or otherwise rendering the paper form unreadable.
Defacing, burning, cutting, or otherwise destroying the bracelet.
Removing the bracelet, or asking someone else to remove it.

A verbal statement in the moment is enough. If you revoke the DNR and later decide you want the order back in place, you have to start over with your physician on a new form.

1
South Carolina Department of Public Health. EMS Protocols, Forms
2
South Carolina Legislature. South Carolina Code Title 44 Chapter 78 – Emergency Medical Services Do Not Resuscitate Order Act
3
South Carolina Department of Public Health. DHEC Restructuring
4
South Carolina Legislature. South Carolina Code Title 44 Chapter 78 – Emergency Medical Services Do Not Resuscitate Order Acta>