A competent person, over the age of eighteen, an authorized decision maker on behalf of the incapacitated person or a surrogate on behalf of a minor may execute an EMS Comfort Care Order.

Complete the EMS Comfort Care Order and have the physician sign the "Physician Certification and Order" and the bracelet inserts at the bottom of the Order. Tear the bracelet insert off the original form, fold it, trim it along the dotted line, and insert it in the temporary vinyl patient bracelet that has been provided. The physician must then place the enclosed patient bracelet on the patient’s arm or wrist.

If a permanent, metal bracelet is desired complete the Oneida Nameplate Co. form enclosed in the EMS Comfort Care Order Kit. A copy of the completed and signed District of Columbia EMS Comfort Care Order must accompany the order form. PLEASE NOTE: EMS personnel will only recognize the specific bracelet design and engravings authorized by DC Law 14-224.

The blue copy of the EMS Comfort Care Order should be mailed to: Government of the District of Columbia, Department of Health, Health Emergency Preparedness and Response Administration (HEPRA), Attn: DNR Program, 64 New York Avenue NE, Suite 5000, Washington, DC 20002.

The EMS Comfort Care Order should be kept in a safe place and shared with family members to gain support of the patient’s end of life wishes. An intact EMS Comfort Care bracelet is the only identifier that will be recognized by EMS personnel for the purposes of withholding cardiopulmonary resuscitation or advanced life support.

If resuscitation has been initiated prior to identifying an intact EMS Comfort Care bracelet, EMS personnel will cease resusciation efforts upon identifiation of the bracelet on the patient's arm or wrist.

An EMS Comfort Care Order may be revoked at any time by the patient’s request for resuscitation made directly to responding emergency medical services personnel OR by defacing or destroying the EMS Comfort Care bracelet OR by directing another person to remove, cut, destroy, deface or discard the bracelet in the presence of the patient, the authorized decision-maker or surrogate. Destruction of an EMS Comfort Care Order or bracelet without consent carries penalties under DC Law.

There is no expiration date for District of Columbia EMS Comfort Care Orders. However, patients, their authorized decision makers, and attending physicians are encouraged to review and re-assess the continuing need, desire, and qualification for an EMS Comfort Care Order.