Out of hospital DNR Texas form – also called the Texas OOH-DNR – is one of the most important advance directive documents a Texas resident can complete. As an attorney who has drafted and reviewed hundreds of Texas advance directives over the last twelve years, I’ve seen firsthand how a properly executed Texas do not resuscitate form gives patients and families peace of mind when seconds count.
In this comprehensive guide I’ll give you a free, attorney-reviewed OOH DNR form Texas PDF template, explain the difference between the out-of-hospital and in-hospital DNR in Texas, walk you through every section of the form, and answer the questions I hear most often in my practice.
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 Texas attorney or your physician before executing any advance directive.
The Texas Out-of-Hospital Do-Not-Resuscitate Order is a physician-signed directive that instructs EMS personnel, first responders, and health care professionals outside of a hospital setting not to perform CPR or certain other life-sustaining procedures if your heart stops or you stop breathing.
Unlike an in-hospital DNR (which only applies inside a hospital or licensed nursing facility), the official out of hospital DNR Texas form is recognized by paramedics in your home, in an ambulance, in an assisted living facility, or during transport.
Source: Texas Health and Safety Code §166.081 – §166.101 (Legislature of the State of Texas) and Texas Department of State Health Services OOH-DNR page.
| Feature | Out-of-Hospital DNR (OOH-DNR) | In-Hospital DNR |
|---|---|---|
| Where it applies | Home, ambulance, hospice, assisted living, anywhere outside hospital | Only inside hospitals and licensed inpatient facilities |
| Who can issue | Your attending physician (MD/DO) | Any treating physician in the facility |
| Form required | Yes – specific DSHS form or approved necklace/bracelet | No specific state form required |
| Identification | Original form, state-approved bracelet, or necklace | Hospital chart order + wristband |
| Revocation | Destroy form/bracelet or tell EMS verbally | Physician removes order from chart |
Download the Official Texas Out-of-Hospital DNR Form (PDF) – Direct from Texas DSHS (last updated 2025)
Descargar Formulario OOH-DNR en Español
Alternative approved identifiers:
• MedicAlert OOH-DNR bracelet (1-800-432-5378)
• Official Texas OOH-DNR necklace
In my experience, 90% of rejected OOH-DNR forms are rejected because of simple execution errors. Follow these steps exactly:
Texas law is very specific (Health & Safety Code §166.085):
Revocation is surprisingly simple and does NOT require a new form:
I always recommend patients write “REVOKED” in large red letters across every copy and destroy bracelets.
No. A living will (Directive to Physicians) only applies when you are terminally ill or irreversibly comatose and in a hospital or nursing home. The OOH-DNR applies immediately, anywhere outside the hospital.
No. Texas EMS only recognizes the official form or DSHS-approved jewelry. A tattoo is not legally binding in Texas.
No. You can still call 911 for pain control, bleeding, or comfort care. The OOH-DNR only limits CPR, defibrillation, intubation, and certain medications if you are in cardiac or respiratory arrest.
No. Hospice patients at home MUST have the Texas Out-of-Hospital DNR form or bracelet to prevent unwanted resuscitation.
Completing a Texas out of hospital DNR form is one of the most loving gifts you can give your family. In my twelve years of practice, I’ve sat with too many families watching EMS perform unwanted CPR because the correct paperwork wasn’t in place.
Download the official form above, have that difficult but necessary conversation with your physician, and keep the original in a bright red envelope on your refrigerator.
Your wishes deserve to be honored – wherever you take your last breath.
Again, this article and template are provided for informational purposes only. Please consult your Texas physician and attorney to ensure your advance directives meet your specific needs and current Texas law.
Sources:
Texas Health & Safety Code Chapter 166 – Advance Directives
IRS.gov Publication 559 (for estate and final medical decision-making authority)
Texas Department of State Health Services – OOH-DNR Program