OFM - Do Not Resuscitate

Do Not Resuscitate Confirmation Form


To obtain a supply of the Do Not Resuscitate (DNR) Confirmation Form, please send your request to the Ministry of Health and Long-Term Care Forms Warehouse by fax to 416-679-8192.

Form Number: 4519-45 (08/01)
Catalogue Number: 7530-5678

Requests should be submitted on official letterhead of the health care provider / institution.  Orders are limited to a maximum of 250 and will be provided at no cost. Note: Each form contains a unique 7-digit serial number.

For additional information regarding the DNR Confirmation Form, please contact the MOHLTC Forms Customer Service Unit at ossdistribution@ontario.ca.