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CPR DNR FORM
Patient Name
Owner Name:
First Name
Last Name
Date
Phone Number
Email
CPR (RESUCITATION) $500 - $800 should be performed on my pet if my pet suffers from cardiac or respiratory.
Resuscitation of an animal that has stopped breathing but still has a heartbeat is more likely to succeed than on an animal that is not breathing and has no heartbeat. Animals that survive a cardiopulmonary arrest and have been successfully resuscitated (CPR) are extremely critical and unstable. Management of the post-arrest patient requires vigilant monitoring and the technical expertise of a dedicated critical care personnel. This estimate is for the initial CPR. An estimate for further care will be provided to you as your pet stabilizes. Typical CPR CRITICAL CARE for the first 24-48 hours post arrest is estimated to be $1,500 - $3,500, dependent on your pet’s injury or condition.
DNR (DO NOT RESUSCITATE) No attempt of CPR Will be provided to your pet should they stop breathing or has no heartbeat. I elect to have DNR orders placed on my pet’s record, thus authorizing staff to discontinue/refrain from all attempts of CPR.
I understand there is NO GUARANTEE of survival and I have read and understand the options of CPR or DNR presented to me.
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