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Virginia Administrative Code
Title 12. Health
Agency 5. Department of Health
Chapter 66. Regulations Governing Durable Do Not Resuscitate Orders
2/28/2026

12VAC5-66-40. The Durable Do Not Resuscitate Order Form.

The Durable DNR Order Form shall be a standardized document approved by the board and consistent with this chapter, including the following requirements:

1. A Durable DNR Order Form shall contain, from a physician with whom the patient has a bona fide physician-patient relationship, a do not resuscitate determination, signature and the date of issue, the signature of the patient, or, if applicable, the person authorized to consent on the patient's behalf.

2. A signed Durable DNR Order shall remain valid until revoked in accordance with § 54.1-2987.1 of the Code of Virginia or until rescinded, in accordance with accepted medical practice, by the provider who issued the Durable Do Not Resuscitate Order.

3. A Durable DNR Order shall be valid for the purposes of withholding or withdrawing cardiopulmonary resuscitation by health care personnel in the event of cardiac or respiratory arrest.

4. An original or a legible photocopy of the Durable DNR Order Form, POST Form, or POLST Form shall be readily available to health care personnel at the patient's current location.

5. Three identical Durable DNR Order Forms shall be filled out and distributed as follows:

a. Copy one - to be kept by the patient.

b. Copy two - to be kept in the patient's permanent record.

c. Copy three - to be used to order Alternate Durable DNR jewelry.

6. A Durable DNR Order or Other DNR Order may only be revoked in accordance with § 54.1-2987.1 D of the Code of Virginia.

Statutory Authority

§§ 32.1-12 , 32.1-111.4, and 54.1-2987.1 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 18, Issue 12, eff. March 27, 2002; amended, Virginia Register Volume 27, Issue 21, eff. July 20, 2011; Volume 42, Issue 10, eff. February 12, 2026.

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