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Yes! You can use AI to fill out Texas Out-of-Hospital Do-Not-Resuscitate (OOH-DNR) Order

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Texas Out-of-Hospital Do-Not-Resuscitate (OOH-DNR) Order, page 1
Complex · 67/100Form Complexity Index

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What this form asks for

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The Texas OOH-DNR Order is a legally binding document that allows an individual to refuse specific resuscitation efforts in an out-of-hospital setting, ensuring their end-of-life wishes are respected. It directs healthcare professionals to forgo treatments such as CPR, defibrillation, and artificial ventilation, allowing for a natural death. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
Fillable fields66
Pages1
Sections15
Tables and lists2
Questions that depend on earlier answers9
Form Complexity IndexComplex, 67/100

The AI checks your answers before you download

12 checks built for this form, so a wrong date or a missing answer is caught before anyone else sees it.

Exclusive Declaration Section Selection

Checks that only one of the declaration sections (A, B, C, D, E, or F) has been completed. Since each section represents a different legal basis for the DNR order, having multiple sections filled creates ambiguity and invalidates the document. If this check fails, the form must be rejected and returned for clarification on which single declaration applies.

Patient Age and Declaration Section Consistency

Validates that the patient's age, calculated from the Date of Birth, is appropriate for the declaration section used. Section E is exclusively for minors (under 18), while Sections A, B, C, D, and F are for adults (18 or older). This check prevents the misapplication of legal standards for minors and adults, which is critical for the order's validity.

Completeness of Patient Identifying Information

Ensures the 'Person's full legal name', 'Date of birth', and a gender selection ('Male' or 'Female') are all provided. This basic information is essential for positively identifying the patient to whom the DNR order applies. An incomplete identification section could lead to the order being applied to the wrong person or being deemed invalid by healthcare professionals.

Valid and Chronological Signature Dates

Verifies that all date fields associated with signatures are valid dates and are chronologically logical. Specifically, all signature dates must be on or after the patient's date of birth and no later than the current processing date. This prevents impossible dates, such as those in the future, and ensures the document was signed in a valid sequence.

Section F Dual Physician Requirement

Confirms that if Section F is completed, all required fields for two distinct physicians are present. This includes the printed name, license number, signature, and date for both the attending physician and the second concurring physician. The validity of a Section F declaration is legally contingent on the documented agreement of two physicians.

Witness or Notary Validation for Sections A, B, C, E

Checks that for declarations made under Sections A, B, C, or E, the form is properly attested by either two qualified witnesses or a notary public. The system must verify that the fields for two witnesses are complete OR the notary section is complete, but not both. This attestation is a legal requirement to confirm the authenticity of the signature, and its absence invalidates the order.

And 6 more checks
  • Exclusion of Witnesses/Notary for Section F
  • Physician's Statement Completeness
  • Declarant Role Selection
  • Physician License Number Format
  • Minor Patient Status for Section E
  • Final Acknowledgment Signature Cross-Validation

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How to Fill Out Texas OOH-DNR Order (Form EF01-11421) Online for Free in 2026

What the AI walks you through.

  1. Navigate to Instafill.ai and upload the Texas OOH-DNR Order form or select it from the template library.
  2. Enter the patient's full legal name, date of birth, and sex in the initial information section.
  3. Identify the declarant by selecting the appropriate section (e.g., the patient, a legal guardian, a qualified relative, or a physician).
  4. Follow the AI-powered prompts to complete the information and signature fields specific to the declarant's section.
  5. Secure the required signatures from the declarant, two qualified witnesses, and the attending physician(s) as applicable.
  6. If required by the chosen declaration method, have the document notarized by a licensed notary public.
  7. Review the entire completed form for accuracy, then download and print it to ensure a copy accompanies the person at all times.

Common Mistakes in Completing Texas OOH-DNR Order (Form EF01-11421)

The ones the AI is built to catch.

Completing an Incorrect or Multiple Declaration Section (A-F)
This form has six distinct sections (A-F) for different declarant situations, such as a competent adult (A), a legal guardian (B), or physicians (F). A common error is filling out the wrong section or multiple sections, which creates ambiguity and can invalidate the entire order. To avoid this, carefully read the instructions for each section to determine the single, correct one that applies to the patient's specific circumstances before filling anything out.
Missing Signatures in the Final Acknowledgment Block
A highly common and critical error is overlooking the final signature block at the bottom of the form, which requires every person who signed above (patient, guardian, witnesses, physicians) to sign again. This second set of signatures acknowledges that the form was completed properly and is often missed because it's an unusual requirement. Missing these final signatures can render the entire document invalid, so it's crucial to double-check that all original signers have also signed in this final section.
Using Unqualified Witnesses
The form requires two competent adult witnesses, but the instructions specify many people who are disqualified, such as relatives, heirs, the attending physician, or certain healthcare facility employees. People often ask a family member or a direct care nurse to witness, which legally invalidates the document. To prevent this, carefully review the 'Qualified Witnesses' definition and select individuals who have no personal, financial, or medical relationship with the patient as outlined.
Incomplete or Missing Physician's Statement
The 'PHYSICIAN'S STATEMENT' is not optional; it is the section where the attending physician officially directs other healthcare professionals to honor the DNR. Mistakes include the physician forgetting to sign, date, or provide their printed name and license number. An incomplete physician's statement means the document is not a valid medical order and will not be honored by first responders, defeating its entire purpose.
Using a Nickname Instead of Full Legal Name
The form asks for the 'Person's full legal name,' but individuals sometimes enter a nickname, a shortened name, or an initial. This can cause significant problems for emergency personnel trying to verify the patient's identity against their ID, potentially delaying or preventing the DNR from being honored. Always enter the full legal name exactly as it appears on official documents like a driver's license or birth certificate.
Forgetting to Date Signatures
Nearly every signature line on the form is accompanied by a field for the date. It is a frequent oversight for signers (including the patient, witnesses, and physicians) to provide a signature but forget to write the corresponding date. A missing date can raise legal questions about when the document was executed and whether it was valid at the time of the medical event, potentially leading to it being disregarded.
Illegible Handwriting on Critical Fields
When this form is printed and filled out by hand, illegible handwriting can make critical information like names, dates, or a physician's license number unreadable. This is especially problematic in an emergency situation where first responders must quickly and confidently interpret the order. Using an AI-powered tool like Instafill.ai can prevent this by converting the flat PDF into a fillable version, allowing you to type information clearly and ensure legibility.
Confusion Between Witness and Notary Requirements
The form offers the option to use a notary public *instead* of two witnesses for certain declarations, but not all. People may mistakenly believe they need both, or they may use a notary for a situation (like a nonwritten declaration) where only witnesses are permitted. This confusion can lead to an improperly executed document. Carefully read the instructions to understand if you need two qualified witnesses or if a notary is a valid alternative for your specific situation.
Missing the Second Physician's Signature in Section F
Section F is a specific declaration used when an incompetent patient has no available representative, and it requires the signature and details of *two* physicians. A frequent mistake is for only the attending physician to complete this section, forgetting the required concurrence and signature from a second, non-involved physician. Without both physician signatures, a declaration made under Section F is incomplete and invalid.
Mismatched Printed Name and Signature
For every signature, there is a corresponding field for a printed name. Errors occur when the printed name is misspelled, incomplete, or does not reasonably match the signature, which can cause confusion about the signer's identity. To avoid this, ensure the printed name is written legibly and is the full, correct name of the person signing. AI form-filling tools like Instafill.ai can help by consistently populating printed names correctly once entered.

Frequently Asked Questions About Texas OOH-DNR Order (Form EF01-11421)

 

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This plan is for your Texas OOH-DNR Order (Form EF01-11421): your own AI agent fills it as often as 5 times a month. To fill other forms and upload your own, choose a Professional plan from your account.
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How does the AI fill out Texas OOH-DNR Order (Form EF01-11421)?
You answer a few questions in plain words, or upload a document you already have. The AI reads what you give it and puts each answer into the right field of Texas OOH-DNR Order (Form EF01-11421), on every page, in seconds. It checks the answers against the form's own rules, and you review and change anything before you download, print or sign.
What happens to my information?
It is encrypted in transit and at rest, and it is never used to train AI.
How complex is Texas OOH-DNR Order (Form EF01-11421) to fill out?
Texas OOH-DNR Order (Form EF01-11421) has a Form Complexity Index of 67 out of 100, in the complex tier: 66 fillable fields across 1 page. Instafill.ai's AI fills it in under a minute, with every field there for you to review before you download.
What is the purpose of the Texas Out-of-Hospital Do-Not-Resuscitate (OOH-DNR) Order form?
This is a legal document that instructs health care professionals in out-of-hospital settings, like an ambulance or a doctor's office, not to perform life-sustaining resuscitation. It is designed to allow a person to have a natural death with peace and dignity.
Who can fill out and sign this form?
A competent adult over 18 can sign for themselves (Section A). If the person is incapacitated, it can be signed by a legal guardian, agent under a medical power of attorney (Section B), a qualified relative (Section C), or under specific circumstances, by physicians (Sections D & F).
What specific medical treatments does this order prevent?
This order directs medical professionals to withhold cardiopulmonary resuscitation (CPR), transcutaneous cardiac pacing, defibrillation, advanced airway management, and artificial ventilation.
If I have an OOH-DNR order, will I still receive comfort care?
Yes, absolutely. This order does not affect the provision of other emergency care, including comfort care, which is given as needed to relieve pain and suffering.
Who needs to sign this form for it to be valid?
The form requires signatures from the person making the declaration (the patient or their representative), two qualified witnesses (or a notary), and the patient's attending physician.
What is the difference between Sections B and C for an incapacitated adult?
Section B is used when the person has a legally appointed guardian, an agent in a Medical Power of Attorney, or a proxy. Section C is used by a qualified relative (like a spouse or adult child) when no such legal representative exists.
Who can be a witness for this form?
Witnesses must be competent adults. At least one witness cannot be related to the person, entitled to any part of their estate, or be the attending physician or their employee.
What should I do with the OOH-DNR form after it's completed?
The original form or a copy must accompany the person, especially during medical transport. It's important to keep it in a location where emergency responders can easily find it.
How can this OOH-DNR order be revoked?
The order can be revoked at any time by the person or their representative. Revocation can be done by verbally telling responders, destroying the form, or removing any OOH-DNR identification devices from the person.
Are there situations where this order is automatically revoked?
Yes, the OOH-DNR order is automatically revoked if the person is known to be pregnant or in the case of an unnatural or suspicious death.
Can I use an AI tool to help me fill out this form?
Yes, services like Instafill.ai use AI to auto-fill form fields accurately and save time, which can be helpful for ensuring all information is entered correctly.
How can I fill out this Texas OOH-DNR form online?
You can upload the form to a service like Instafill.ai, which makes the document interactive. This allows you to type in your information, add digital signatures, and then download the completed form.
The PDF version of this form I found is not fillable. What can I do?
If you have a non-fillable PDF, you can use a platform like Instafill.ai. It can convert flat PDFs into interactive, fillable forms that you can complete and sign on your computer.
Does my doctor need to be involved to complete this form?
Yes, the patient's attending physician must sign the Physician's Statement on the form. This signature directs other health care professionals to honor the order and confirms it has been noted in the patient's medical records.
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