New Hampshire's statutory out-of-hospital Do Not Resuscitate order is a bright pink form, with a detachable wallet card, recognized statewide by EMS. It applies only when the patient has no pulse and is not breathing, and it means no chest compressions, intubation, assisted ventilation, defibrillation or resuscitation drugs. Clinicians complete it after discussing resuscitation with the patient, and it is required for a DNR bracelet or necklace.
A licensed MD, DO, APRN or PA signs Section A with name, title, date and time; the patient, parent of a minor, durable power of attorney for health care agent or guardian also signs. Section B records advance directives and their locations, and both sign the wallet card.
Download the current version from the source each time; forms change without notice.
New Hampshire Portable Do Not Resuscitate (P-DNR) Order
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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No. Under state law, a DNR bracelet or necklace may only be issued to patients who have a valid DNR order, such as the P-DNR or a POLST stating it is a DNR. The P-DNR wallet card should be carried at all times, even if the patient also wears a bracelet.
Yes. All forms of DNR order remain valid during a transfer from one health care facility to another, and the original pink form should travel with the patient. A DNR written inside a facility under its own policies is valid only while the patient resides there, and the P-DNR should be reviewed on admission to a new facility.