Indiana Code Title 16. Health § 16-36-5-19

(1) an original or a copy of a signed out of hospital DNR declaration and order executed by the patient;  or

(2) an out of hospital DNR identification device worn by the patient or in the patient's possession.

(1) the declarant is conscious and states a desire for resuscitative measures;

(2) the health care provider believes in good faith that the out of hospital DNR declaration and order has been revoked;

(3) the health care provider is ordered by the attending physician, advanced practice registered nurse, or physician assistant to disregard the out of hospital DNR declaration and order;  or

(4) the health care provider believes in good faith that the out of hospital DNR declaration and order must be disregarded to avoid verbal or physical confrontation at the scene.

(1) the presence of an out of hospital DNR declaration and order;

(2) the attending physician's, advanced practice registered nurse's, or physician assistant's name;  and

(3) the date the out of hospital DNR declaration and order was signed.