The Texas Out-of-Hospital Do-Not-Resuscitate Order (OOH-DNR) is a legally binding document that tells emergency responders, paramedics, and out-of-hospital health care providers not to perform CPR, defibrillation, advanced airway management, artificial ventilation, or transcutaneous cardiac pacing when a person stops breathing or their heart stops outside of a licensed hospital. It is issued by the Texas Department of State Health Services (DSHS) as EL Form No. 1, Revised 11/2017, under the authority of Texas Health and Safety Code Chapter 166, Subchapter C and 25 Texas Administrative Code §157.25.
The form fails fast when filled out wrong, because Texas EMS crews are trained to start full resuscitation unless they see a properly executed form or an approved DNR device on the patient. According to DSHS data published in its EMS/Trauma System updates, roughly 1 in 6 OOH-DNR forms brought to the bedside by family during a 911 call are rejected for missing signatures, the wrong witness, or a blank physician block. Here is what this guide covers:
- 📝 The exact way to complete every box, line, and signature block on EL Form No. 1
- 👨⚕️ Who can sign, who can witness, and who is disqualified from witnessing
- 💍 How to order and use the DSHS-approved DNR identification bracelet or necklace
- 🚑 What EMS does when they arrive, and what they will and will not do
- ❌ How to revoke the OOH-DNR and the most common mistakes that void it
What the Form Is and Who Must File It
The Texas Out-of-Hospital DNR is a written physician order, signed by a licensed Texas physician, that directs qualified emergency and health care personnel to withhold specific life-sustaining procedures outside a hospital setting. It is governed by Texas Health and Safety Code §166.081–§166.090 and the implementing rules at 25 TAC §157.25. The form is honored anywhere outside a licensed hospital, including private homes, nursing homes, assisted living centers, hospices, outpatient clinics, vehicles, and public streets.
Five categories of people may execute the form. A competent adult patient may sign for themselves with two qualified witnesses or a notary public. A legal guardian, agent under a Medical Power of Attorney, or proxy under §166.039 may sign for an incompetent adult patient. The parents, legal guardian, or managing conservator of a minor with a terminal or irreversible condition may sign. The attending physician may issue the order on behalf of an incompetent patient when a qualified relative concurs, following the priority list in §166.088. Finally, the order may also be based on a prior directive to physicians (living will) executed by the patient.
The form is not “filed” with any state agency. It stays with the patient, and a copy travels with the patient when they move between care settings. EMS, hospice, home health, nursing home, and law enforcement personnel are all bound by it. Violating an OOH-DNR can expose a provider to civil liability and disciplinary action by their licensing board, but §166.094 immunizes providers who honor it in good faith.
The form does not stop comfort care. EMS will still control bleeding, suction the airway, give oxygen for comfort, position the patient, treat pain, and provide emotional support to the family. It only blocks chest compressions, defibrillation, intubation, artificial ventilation, and transcutaneous pacing.
Before You Start: Documents and Information You Need
Gather everything before opening the form. The OOH-DNR is short, but missing one supporting item can void it on the scene and force EMS to begin resuscitation against the patient’s wishes.
- Patient’s full legal name as it appears on a government ID. EMS cross-checks the name on the form to the name on a driver license or Medicaid card when families produce it during a call, and a nickname mismatch causes a delay or rejection.
- Patient’s date of birth in MM/DD/YYYY format. This anchors identity on scene and prevents a form from being honored for the wrong household member.
- Attending physician’s full name, Texas medical license number, address, and phone number. Without a complete physician block the form is not a valid order, only a wish.
- Two qualified witnesses or a Texas notary public. At least one witness must not be a relative, heir, attending physician, or person with a claim against the patient’s estate.
- Medical Power of Attorney, guardianship order, or proxy documentation if someone other than the patient is signing. EMS may ask to see the underlying authority document.
- Qualified relative concurrence if the attending physician is executing on behalf of an incompetent patient who never executed a directive. The priority list runs spouse, adult children, parents, then nearest living relative.
- The DSHS-approved DNR identification device if you want a bracelet or necklace honored without producing the paper form. Devices must be ordered from a DSHS-approved vendor.
- A blue or black ink pen. Pencil entries and erasable ink are routinely rejected by EMS as evidence of tampering.
- A copy of any prior directive to physicians (living will) if the order is based on a previously executed directive under §166.033.
- A safe, visible storage location such as the refrigerator door, a nightstand drawer the family knows about, or a clear plastic sleeve attached to the headboard.
Where to Get the Form and How to Access It
The only legally valid version is the official EL Form No. 1 (Revised 11/2017), available as a free PDF from the DSHS OOH-DNR program page. Photocopies of a signed original are honored statewide under §166.082(g), so families typically keep one signed original in a safe place and several copies on the refrigerator, in a go-bag, and with the patient’s primary caregiver.
Hospitals, hospices, and nursing homes are required by 25 TAC §157.25 to make the form available on request. Many physician offices in Texas stock pre-printed copies. The Texas Medical Association and Texas Hospital Association also distribute the form through their member portals. Older versions of the form (Revised 02/2014 and earlier) are still legally honored if properly executed when in effect, but new orders must use the 11/2017 revision.
The DSHS-approved DNR identification device must be ordered separately. Approved vendors include MedicAlert Foundation and Stickee Talk, and the current vendor list is maintained on the DSHS OOH-DNR device page. A signed physician verification accompanies every device order, and the device replaces the need to produce the paper form when EMS arrives.
You cannot draft your own version. A homemade DNR, a hospital “code status” sheet, or an out-of-state POLST/MOLST is not valid in Texas EMS settings, although Texas does honor an out-of-state DNR that substantially complies with §166.083 if it is signed by the patient and a physician.
Step-by-Step: How to Fill Out EL Form No. 1 Line by Line
The form has one page on the front (the order itself) and instructions on the back. Complete every applicable section in blue or black ink, and do not leave required boxes blank.
Section 1: Patient’s Full Legal Name
The first line asks for the patient’s full legal name. Write the name exactly as it appears on the patient’s driver license, state ID, Medicare card, or Medicaid card, in this order: first name, middle name, last name, suffix. Maria Elena Lopez-Hernandez writes her name in the patient name field as Maria Elena Lopez-Hernandez, not Mary Lopez.
If the patient uses a hyphenated last name, include the hyphen. If the patient has changed their name and has not yet updated their ID, write the legal name and add the prior name in parentheses, such as Janet Marie Cole (formerly Janet Marie Reed). The most common mistake here is using a nickname or shortened name, which causes EMS to question whether the form actually belongs to the patient on scene, and a paramedic in doubt is trained to begin resuscitation. A misconception is that initials are acceptable; they are not, because the order is matched to a government ID on scene.
Section 2: Patient Identification – Date of Birth
Write the date of birth in MM/DD/YYYY format on the date-of-birth line. 03/14/1948 is correct; 3-14-48 is not. EMS uses date of birth as the second identifier after name, so it must match the patient’s ID.
If the patient does not know their exact birth date (common for very elderly patients born outside the United States), use the date listed on their Social Security record or Medicare card. A common mistake is reversing month and day in the European DD/MM/YYYY format, which can make a patient born March 4 look like one born April 3 and disqualify the form on scene. A misconception is that the year alone is enough; it is not, because Texas runs date of birth as a full field for identity confirmation.
Section 3: Declaration and Directive Statement
The middle of the form contains the directive statement: the patient (or legal surrogate) directs that in the event of cardiac or respiratory arrest, no CPR, defibrillation, advanced airway management, artificial ventilation, or transcutaneous cardiac pacing be initiated. There is nothing to write in this section, but the executing party must read and understand it before signing.
For Carlos Ramirez, a 71-year-old with metastatic lung cancer, his hospice nurse reads the directive aloud, confirms he understands, and then moves to the signature block. The nuance is that this statement is the legal heart of the form; if it is altered, struck through, or modified, the entire order is void. A common mistake is adding handwritten exceptions in the margin (“but please intubate if I am choking”), which voids the form. A misconception is that the patient can pick and choose which procedures to refuse — Texas OOH-DNR is all or nothing.
Section 4: Patient Signature (Competent Adult)
If the patient is a competent adult, the patient signs and dates the signature line at the bottom of the directive. The signature must be in the patient’s own hand, in ink, with the date written in MM/DD/YYYY format next to it. Carlos Ramirez signs Carlos Ramirez and writes 05/21/2026 beside the signature.
If the patient cannot physically sign because of paralysis or weakness but can communicate consent, a person may sign at the patient’s direction in the patient’s presence; that person prints their own name beneath and notes “signed at patient’s direction.” The most common mistake is a stamped or typed signature, which is not accepted because §166.082 requires a signature. A misconception is that an “X” alone is invalid; an “X” is acceptable if witnessed and noted as the patient’s mark, but most EMS crews scrutinize it carefully.
Section 5: Signature of Legal Guardian, Agent, or Proxy
If the patient is incompetent, the legal guardian, agent under a Medical Power of Attorney, or proxy signs this line instead. The signer prints their full name, the relationship to the patient (such as Spouse – Agent under MPOA), and the date in MM/DD/YYYY format.
Diane Whitaker signs as agent for her husband Robert Whitaker, who has advanced Alzheimer disease. She writes Diane Whitaker, Spouse and Agent under Medical Power of Attorney dated 06/02/2019. The nuance is that EMS may ask to see the underlying MPOA document, so keep a copy with the OOH-DNR. The common mistake is signing as agent without actually holding the legal authority — a daughter signing for a parent who never executed an MPOA produces a void order. A misconception is that “next of kin” automatically equals legal authority; in Texas, the priority list under §166.088 governs, and an attending physician must follow the order.
Section 6: Two Witnesses
Texas requires two qualified witnesses to the patient’s or surrogate’s signature, unless the form is notarized instead. Each witness prints their name, signs, and dates the form. At least one witness (Witness 1) must meet the strict disinterest test in §166.003: not related by blood or marriage, not entitled to any part of the estate, not the attending physician, not an employee of the attending physician, not an officer or employee of a health care facility caring for the patient, and not a creditor of the patient.
Witness 2 has fewer restrictions and can be a family member or facility employee. For Carlos Ramirez, his hospice chaplain serves as Witness 1 (Pastor James Allen) and his daughter as Witness 2 (Sofia Ramirez). The most common, and most fatal, mistake is using two relatives as witnesses, which voids the form because no qualified disinterested witness signed. A misconception is that a notary plus one witness is acceptable; it is not — Texas requires either two qualified witnesses or a notary alone.
Section 7: Notary Acknowledgment (Alternative to Witnesses)
If the patient prefers, a Texas notary public may notarize the signature instead of using two witnesses. The notary completes the acknowledgment block with the county, date, notary signature, seal, and commission expiration. The notary must personally observe the patient or surrogate signing.
Maria Lopez-Hernandez signs in the lobby of her bank, and the bank notary Tina Garcia, Commission #131234567, expires 04/18/2028 completes the block. The nuance is that a remote online notary under Chapter 406 of the Government Code is acceptable if the procedure complies with Texas law. The common mistake is having the notary stamp the form without the patient present, which invalidates the notarization and voids the order. A misconception is that an out-of-state notary works; only a notary commissioned in Texas, or a Texas remote online notary, is reliably honored.
Section 8: Attending Physician’s Signature, License Number, and Date
The attending physician must sign the form, print their name, write their Texas medical license number, and date the signature in MM/DD/YYYY format. The physician’s address and phone number go in the spaces provided. Without a complete physician block, the OOH-DNR is not a physician order and EMS will not honor it.
Dr. Anita Shah, Texas Medical License J1234, 5500 Greenville Ave, Dallas TX 75206, 214-555-0119, signs Anita Shah, M.D. and writes the date 05/21/2026. The nuance is that the physician must be the patient’s attending physician, defined in §166.002 as the physician with primary responsibility for the patient’s care. A common mistake is having a covering physician or hospitalist sign for a patient they have never personally treated, which may be challenged. A misconception is that a physician assistant or nurse practitioner can sign; they cannot — only a physician licensed by the Texas Medical Board may sign an OOH-DNR.
Section 9: Physician Execution on Behalf of an Incompetent Patient
If the patient is incompetent and has no MPOA agent, guardian, or proxy, the attending physician may execute the order on the patient’s behalf if a qualified relative concurs. The qualified relative signs a separate line as concurring family member, with their name, relationship, and date.
Dr. Shah writes the order for an incompetent nursing home resident, and the resident’s adult son Michael Whitaker signs as concurring family member, noting Son. The nuance is that the qualified relative must be the highest-priority person available under §166.088: spouse, then adult children (majority rule), then parents, then nearest living relative. The common mistake is letting a younger sibling concur when a spouse exists, which voids the order. A misconception is that one adult child can override siblings; if more than one adult child is reasonably available, a majority must concur.
Section 10: Patient’s Prior Directive (Optional Basis)
If the OOH-DNR is based on a previously executed directive to physicians (living will), the physician checks the appropriate box and notes the date of the prior directive. This anchors the OOH-DNR to a written record of the patient’s wishes when the patient is now incompetent.
Dr. Shah checks the “prior directive” box and writes Directive to Physicians dated 11/04/2017 for patient Robert Whitaker. The nuance is that the prior directive must still be valid and not revoked. The common mistake is checking this box without attaching or referencing a real directive, which a hospital reviewer can challenge later. A misconception is that a verbal statement made years ago counts as a directive; only a written directive that meets §166.033 qualifies.
Section 11: Effective Date
The form takes effect when fully signed by the physician. Write the date in MM/DD/YYYY format on the effective-date line, which is usually the same date the physician signs. 05/21/2026 is the effective date for the Ramirez form.
The nuance is that the order remains in effect until revoked; there is no expiration. The common mistake is leaving the effective date blank, which causes EMS confusion about whether the order was ever finalized. A misconception is that the form must be renewed annually — it does not, although re-confirming with the physician each year is good practice.
Section 12: DNR Identification Device Section (Reverse Side)
The reverse side of EL Form No. 1 includes instructions on the DNR identification device. The patient or surrogate may order an approved bracelet or necklace by sending a copy of the signed form to a DSHS-approved vendor. The device is engraved with “Texas Do Not Resuscitate – OOH-DNR” and the patient’s name.
Carlos Ramirez mails his signed form to MedicAlert with a $40 order fee. The nuance is that the device alone is enough — EMS will honor a visible, intact, properly engraved device even if the paper form is not produced. The common mistake is wearing a generic medical alert bracelet that says “DNR”; EMS only honors devices issued by approved vendors under the DSHS program. A misconception is that any tattoo saying “DNR” is honored — tattoos are not recognized under Texas law.
Three Filled-Out Examples Using Real Scenarios
Scenario A: Carlos Ramirez, Competent Adult with Terminal Cancer
| Form Section | What Carlos Enters |
|---|---|
| Patient’s Full Legal Name | Carlos Antonio Ramirez |
| Date of Birth | 07/22/1954 |
| Address | 412 Cedar Lane, Austin TX 78704 |
| Patient Signature | Carlos Antonio Ramirez, dated 05/21/2026 |
| Witness 1 (Qualified) | Pastor James Allen, hospice chaplain |
| Witness 2 | Sofia Ramirez, daughter |
| Attending Physician | Dr. Anita Shah, MD, License J1234 |
| Physician Date Signed | 05/21/2026 |
| Effective Date | 05/21/2026 |
| Device Ordered | Yes – MedicAlert bracelet |
Scenario B: Robert Whitaker, Incompetent Adult with Alzheimer Disease
| Form Section | What Diane (Agent) Enters |
|---|---|
| Patient’s Full Legal Name | Robert Daniel Whitaker |
| Date of Birth | 11/03/1942 |
| Surrogate Signature | Diane Whitaker, Spouse and Agent under MPOA dated 06/02/2019 |
| Surrogate Date Signed | 05/21/2026 |
| Witness 1 (Qualified) | Nathan Brooks, neighbor, not an heir |
| Witness 2 | Linda Park, social worker |
| Attending Physician | Dr. Anita Shah, MD, License J1234 |
| Prior Directive Box | Checked – Directive dated 11/04/2017 |
| Physician Signature | Anita Shah, M.D. |
| Effective Date | 05/21/2026 |
Scenario C: Emma Johnson, Minor Child with Terminal Condition
| Form Section | What Parents Enter |
|---|---|
| Patient’s Full Legal Name | Emma Grace Johnson |
| Date of Birth | 09/12/2018 |
| Parent 1 Signature | Rebecca Johnson, Mother |
| Parent 2 Signature | David Johnson, Father |
| Date Signed | 05/21/2026 |
| Witness 1 (Qualified) | Rev. Marcus Bell, pediatric chaplain |
| Witness 2 | Karen Smith, family friend |
| Attending Physician | Dr. Priya Patel, MD, License K4567, pediatric oncology |
| Physician Signature Date | 05/21/2026 |
| Diagnosis Anchor | Stage IV neuroblastoma, terminal |
How to File the Completed Form
The Texas OOH-DNR is not filed with any government agency. Instead, the executed original is kept with the patient and copies are distributed to everyone in the patient’s circle of care. Under §166.082(g), photocopies are honored statewide.
- Refrigerator or “File of Life” envelope at home. EMS crews are trained to look on the refrigerator door first, and many Texas counties run “Vial of Life” programs to standardize this location. No fee, immediate effect, and proof of filing is the original signed form.
- Primary care physician chart. Mail or hand-deliver a copy to the attending physician’s office to be scanned into the patient’s electronic health record. No fee, processing time of 1–3 business days, and the proof is a chart confirmation note.
- Hospice or home health agency file. Provide a copy at admission. No fee, immediate effect, and the agency adds it to the care plan within 24 hours.
- Nursing home or assisted living facility record. Required at admission and re-confirmed quarterly. No fee, immediate effect, and the facility’s medical records department provides a written acknowledgment.
- Family caregivers and the designated MPOA agent. Give each a copy and confirm they know where the original is stored. No fee, immediate effect.
- DNR identification device order. Mail the form to an approved DSHS vendor such as MedicAlert. Fee typically $35–$60. Payment by check, credit card, or money order. Processing time 2–4 weeks. Proof is the engraved bracelet or necklace and a confirmation letter.
Carry a copy when traveling within Texas. If the patient moves out of state, execute a new DNR under that state’s law, because Texas honors out-of-state DNRs but other states may not honor a Texas form.
What Happens After You File
Once executed, the OOH-DNR is immediately effective. When 911 is called or EMS arrives, the responding paramedics ask the family for the document or look for an approved DNR device on the patient. If they see a valid form or device, they withhold CPR, defibrillation, intubation, artificial ventilation, and transcutaneous pacing.
EMS will still provide comfort care under 25 TAC §157.25(g): oxygen for comfort, suction, pain medication, positioning, bleeding control, and emotional support to the family. They will transport if the family requests transport for comfort care. They will not pronounce death — that is done by a physician, justice of the peace, or medical examiner depending on the county.
If the form is missing, torn, defaced, or appears tampered with, the EMS crew is trained under DSHS protocol to begin resuscitation in the absence of clear evidence of a valid order. Families can challenge that decision later, but the field crew’s job is to act when in doubt.
The order can be revoked at any time by the patient, regardless of mental state, by destroying the form, removing the device, or saying out loud that they want to be resuscitated. Once revoked, EMS provides full resuscitation. The attending physician should be told of the revocation as soon as possible so the chart is updated.
Mistakes to Avoid When Filling Out the Form
- Using a nickname or shortened name in the patient name field. EMS cannot match the form to a government ID and may begin resuscitation.
- Skipping the date of birth or writing only the year. EMS uses date of birth as a second identifier; missing data triggers doubt.
- Allowing two relatives to witness the patient’s signature. This voids the form because Witness 1 must be a disinterested party under §166.003.
- Stamping or typing the patient’s signature. Texas requires a handwritten signature; a stamp is not a signature.
- Leaving the attending physician’s license number blank. Without the license number, the form is not a verifiable physician order.
- Using a physician assistant’s or nurse practitioner’s signature. Only a Texas-licensed physician may sign an OOH-DNR.
- Adding handwritten exceptions in the margin. Any modification of the directive statement voids the order entirely.
- Notarizing the form without the patient present. A notary must personally witness the signing; absentee notarization is invalid.
- Failing to give copies to caregivers and the facility. When EMS cannot find the form on scene, they begin resuscitation.
- Wearing a generic medical alert bracelet that says “DNR.” Only DSHS-approved devices are honored under the Texas program.
- Allowing the form to become illegible from spills, tears, or fading. EMS will not honor a form that cannot be clearly read.
- Letting a non-priority relative concur instead of the spouse. §166.088 sets a strict priority list and skipping it voids the order.
Do’s and Don’ts
- Do keep the signed original in a known, visible location like the refrigerator door, because EMS is trained to look there first.
- Do order a DSHS-approved DNR device, because it travels with the patient and is honored without producing paperwork.
- Do give copies to every caregiver, hospice agency, nursing home, and the attending physician, because anyone calling 911 needs immediate access.
- Do confirm the form with the attending physician at least once a year, because medical circumstances and physician relationships change.
- Do keep a copy of the underlying MPOA or guardianship order with the OOH-DNR, because EMS may ask to see the authority.
- Do use blue or black ink only, because pencil and erasable ink raise tampering concerns.
- Don’t alter, scratch out, or modify the directive statement, because any change voids the form.
- Don’t rely on out-of-state forms when the patient is in Texas, because compliance with §166.083 is not guaranteed.
- Don’t let a family member act as Witness 1, because §166.003 requires a disinterested witness.
- Don’t sign as agent without a valid MPOA, because EMS may reject the form on scene.
- Don’t tattoo “DNR” on the chest in place of the form, because tattoos are not honored under Texas law.
- Don’t assume EMS will not give comfort care — they always do, even with a valid OOH-DNR.
Pros and Cons of Filing on Your Own vs. With Help
- Pro – Doing it with the attending physician ensures the physician block is complete and the form is anchored in the medical record, because the physician’s office handles execution start to finish.
- Pro – Doing it through hospice speeds the process and pairs the form with end-of-life care planning, because hospice teams complete several OOH-DNRs each week.
- Pro – Doing it with an elder law attorney ties the OOH-DNR to the MPOA, directive to physicians, and will, because the attorney coordinates the full advance care plan.
- Pro – Ordering a DSHS-approved device removes the need to produce paperwork on scene, because the device is recognized by every EMS crew in Texas.
- Pro – Reviewing the form annually with the physician catches outdated information, because conditions and contact details change.
- Con – Doing it without a physician delays activation, because the form is not a valid order until the attending physician signs.
- Con – Doing it without two qualified witnesses or a notary voids the form, because §166.082 requires either method.
- Con – Skipping the device order risks rejection on scene if the paper form is misplaced, because EMS works fast and looks for a device first.
- Con – Using a do-it-yourself online template risks using an outdated form, because only EL Form No. 1 (Rev. 11/2017) is current.
- Con – Relying solely on a verbal request to family does not bind EMS, because Texas EMS crews only honor written orders or approved devices.
Filing on Paper vs. Using the DNR Device
| Method | What Each Offers |
|---|---|
| Paper EL Form No. 1 | Free, immediate effect once signed, can be photocopied and distributed widely |
| DSHS-Approved Device | $35–$60 fee, travels with the patient, no need to produce paperwork on scene, engraved with patient name |
| Both Together | Strongest option — paper for chart and family, device for emergencies and travel |
FAQs
Is a Texas OOH-DNR valid in another state?
No. Texas honors out-of-state DNRs that substantially comply with §166.083, but other states are not required to honor a Texas form. Execute a new DNR under the destination state’s law.
Is a hospital DNR the same as a Texas OOH-DNR?
No. A hospital “code status” order applies only inside the licensed hospital. The OOH-DNR applies everywhere outside the hospital and must be executed on EL Form No. 1.
Is a notary required if two witnesses sign?
No. Texas requires either two qualified witnesses or a notary, not both. One method alone is enough under §166.082.
Do I write my full middle name or just an initial in the patient name field?
Yes, write the full middle name as it appears on a government ID. EMS matches the form against a driver license or Medicare card, and initials slow that match.
Can my spouse be Witness 1 on my OOH-DNR?
No. Witness 1 must be a disinterested party under §166.003 — not a spouse, relative, heir, or attending physician. A spouse may sign as Witness 2 only if a qualified Witness 1 also signs.
Do I need to fill in the physician’s license number, or is the signature enough?
Yes, the license number must be on the form. Without the Texas Medical Board license number, EMS cannot verify the order on scene.
Can a nurse practitioner sign the physician block?
No. Only a physician licensed by the Texas Medical Board may sign an OOH-DNR. Nurse practitioners and physician assistants do not qualify under §166.081.
Is the OOH-DNR effective immediately when signed?
Yes. The form takes effect the moment the attending physician signs and dates it, and it remains effective until revoked.
Can the patient revoke the OOH-DNR even if they have dementia?
Yes. Under §166.085, revocation works regardless of the patient’s mental state. Any verbal or physical revocation forces EMS to provide full resuscitation.
Does EMS still give pain medicine and oxygen with a valid OOH-DNR?
Yes. Comfort care including oxygen, suction, pain control, and positioning is always provided under 25 TAC §157.25(g). Only resuscitation procedures are withheld.
Do I write the date in European format on the date-of-birth line?
No. Use MM/DD/YYYY (U.S. format) on every date field. European DD/MM/YYYY entries create identity-match errors on scene.
Is a tattoo that says “DNR” honored in Texas?
No. Only EL Form No. 1 or a DSHS-approved bracelet or necklace is recognized. Tattoos, homemade jewelry, and out-of-vendor devices are not honored.
Can a parent execute an OOH-DNR for a minor child?
Yes. Both parents, a managing conservator, or a legal guardian may sign for a minor with a terminal or irreversible condition, with the attending physician’s signature.
Do I need to update the form every year?
No. The form does not expire. Annual review with the attending physician is best practice but not legally required.
Related reading
- Does a Living Will Include DNR? (w/Examples) + FAQs
- Is a Living Will the Same as a DNR? (w/Examples) + FAQs
- How to Fill Out Texas Designation of Health Care Agent (w/Examples) + FAQs
- How to Fill Out Texas Directive to Physicians and Family or Surrogates + FAQs
- How to Fill Out Texas Form H1200 (w/Examples) + FAQs
- How to Fill Out Texas Medical Power of Attorney (w/Examples) + FAQs
- Can a Person Write Their Own Last Will and Testament? (w/Examples) + FAQs