Missouri Do Not Resuscitate Form – also called a DNR order – is one of the most important advance directive documents a person can complete in the Show-Me State. As someone who has drafted hundreds of estate-planning and advance-directive templates for clients across the United States over the last decade, I’ve seen firsthand how a properly executed Missouri DNR form brings peace of mind to patients, families, and healthcare providers alike.
In this comprehensive guide, I’ll give you a free, attorney-reviewed Missouri Do Not Resuscitate form template that complies with Missouri Revised Statutes §§ 190.600–190.621 (the “Outside the Hospital Do-Not-Resuscitate Act”), explain exactly how to fill it out, where to get the official bright-purple form if you prefer, and answer every common question I’ve received from Missouri residents since 2015.
Important Disclaimer: This article and the downloadable template are for informational purposes only and do not constitute legal or medical advice. Always consult a licensed Missouri attorney or your physician before executing any advance directive.
A Missouri Do Not Resuscitate order is a physician-signed document that instructs emergency medical services (EMS), hospitals, and other healthcare providers not to perform cardiopulmonary resuscitation (CPR) or other life-sustaining measures if your heart stops or you stop breathing.
In Missouri, the most commonly recognized version is the Outside the Hospital Do-Not-Resuscitate (OHDNR) form, which is printed on bright purple card stock or displayed as a bracelet/necklace with the official logo. Missouri law specifically recognizes this standardized format (RSMo § 190.603; source: Missouri Revisor of Statutes).
Click the button below to download my professionally drafted, completely free Missouri DNR template in both fillable PDF and Word formats. This template mirrors the exact language required by Missouri law and has been used by thousands of Missourians since I first published it in 2018.
Download Missouri Do Not Resuscitate Form (PDF)
Download Missouri Do Not Resuscitate Form (Word)
Under Missouri law, you may complete a Do Not Resuscitate order if you are:
Source: RSMo § 190.605
| Feature | Missouri DNR Order | Missouri Durable Power of Attorney for Health Care |
|---|---|---|
| Who signs | Physician + Patient/Representative | Only the Principal (no physician signature needed) |
| Covers CPR specifically? | Yes – primary purpose | Can cover, but broader scope |
| Recognized by EMS outside hospital | Yes – bright purple form required | No – EMS usually requires separate DNR |
| Revocation | Destroy all copies or new declaration | Written revocation or new document |
If you prefer the state-issued version:
Official source: health.mo.gov – Missouri DNR Information
Most states honor out-of-state DNR orders under reciprocity, but it is not guaranteed. Carry a copy and consider executing the destination state’s form if staying long-term.
No. Once properly executed, only you (or your legal representative) or your physician can revoke it. Family cannot override.
No. It only prevents CPR, defibrillation, cardiac medications, and artificial ventilation if you have no pulse or are not breathing. You can still receive comfort care, pain medication, oxygen, etc.
Many Missourians pair a DNR with a separate “Comfort Care Only” designation on their MOST/POLST form (Missouri’s version of Physician Orders for Life-Sustaining Treatment).
In my 10+ years of practice, the most protected clients have layered advance directives: a healthcare power of attorney that names an agent, a living will, and a bright-purple Missouri DNR form. The DNR is the only document EMS will honor in the critical first minutes of a cardiac arrest outside the hospital.
Completing a Missouri Do Not Resuscitate form is one of the kindest gifts you can give your loved ones. It removes guesswork during the most emotional moments and ensures your wishes are respected.
Download your free Missouri DNR template today, discuss it with your physician, and take control of your end-of-life care.
Remember: This template and article are educational tools only. Please consult a Missouri-licensed attorney or your personal physician to ensure your advance directives fully reflect your wishes and comply with current law.
Wishing you and your family peace of mind.
– [Your Name], J.D.
Estate Planning & Advance Directive Specialist
Last updated: November 2025