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Home > Guides > Faxing a DNR order
Yes, in many cases a facility will accept a faxed DNR order, but acceptance depends on the facility, the state or province, and whether the copy is clear and complete. Call first, send every page, and confirm receipt by phone, because a fax sitting unread in a tray does not stop treatment.
A DNR order, short for do-not-resuscitate order, is a medical order written by a doctor or other authorized clinician. It tells care teams not to start CPR if the patient's heart stops or breathing stops. Hospitals, nursing homes, hospices, and home-care agencies often need the order on file before they can follow it, and faxing is still a common way to move it from one care setting to another. A patient moving from a hospital to a nursing home, or from home care to hospice, may need the order to arrive before the transfer does.
Faxing fits this job because the receiving facility usually wants a signed document it can file in the chart, not a verbal report. A fax arrives as a document, with a timestamp and a sender number, and it can be filed right away. That said, a faxed DNR order is only useful once a clinician at the receiving end has seen it, checked it, and entered it into the patient's active orders. The fax machine receiving it is not the same as the care team acting on it.
Most facilities accept a clear faxed copy for day-to-day care, and many state and provincial rules treat a faxed copy of a medical order as valid once a clinician verifies it. But rules differ, and some facilities have their own policy that goes further than the law. A hospital may accept a faxed copy on admission and then ask for the original within a set window. A nursing home may want the original filed in the chart before the patient arrives. A hospice nurse visiting at home may work from a faxed copy taped inside the care binder until the original catches up.
The practical move is to ask the receiving facility two questions before you send anything: do you accept a faxed DNR order, and do you need the original as well? Get the name of the person who answers. If they say the original must follow, send the fax first for speed, then mail or hand-deliver the original and note the date you sent it.
| Situation | What usually happens | What to do |
|---|---|---|
| Hospital to nursing home transfer | Faxed copy accepted for admission, original requested for the chart | Send the fax, then send the original with the transfer papers |
| Home hospice setup | Faxed copy kept in the home care binder | Confirm the nurse has it before the first visit |
| New facility, no prior record | Staff verify the order with the issuing clinician | Include the issuing doctor's name and phone number on the cover note |
| Unclear or partial fax | Staff hold off until they can read every line | Resend at higher contrast and call to confirm |
Send every page of the order, not just the signature page. A DNR form often runs to more than one page, and the pages that state the scope of the order matter as much as the signature. Include a short cover note with the patient's full name and date of birth, the name of the sending facility or clinician, a callback number, and the number of pages. Do not add extra medical records that the facility did not ask for; a DNR fax should carry the order and the cover note, nothing more.
Check the copy before you send it. DNR forms are often filled in by hand, and handwriting that looks fine on paper can turn to mush on a fax. If the form is faint, photocopy it darker first, or scan it and send from a clean copy. After sending, call the facility and ask a specific person to confirm they can read it and have filed it. Ask them to read back the patient's name and the date on the order. That call is what turns a sent fax into a received order.
If a patient is being transferred within hours, say so on the cover note and on the phone call, and ask for the name of the nurse or administrator who will file it. If the facility's fax line is busy or the copy keeps arriving unreadable, ask whether they accept a scanned copy by secure email or a hand-delivered copy from the transport team. Do not assume an unconfirmed fax protects the patient. Until someone at the receiving facility confirms the order is in the chart and active, the default in an emergency is usually to attempt resuscitation, because staff act on the orders they can see.
Keep the fax confirmation page with the patient's records, and note the date, time, number dialed, and the name of the person who confirmed receipt. If the patient moves again, the same steps repeat: new facility, new fax, new confirmation call.
LetterAgent faxing is available in testing for US and Canadian fax numbers, with a per-fax quote you approve before anything is sent. It does not receive faxes, and it cannot confirm that a facility has filed an order; that confirmation still comes from a phone call to the facility itself.
This is general information, not legal advice.
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