Get Sample Polst Form - Chausa
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How to use or fill out the Sample POLST Form - CHAUSA online
Filling out the Sample POLST Form - CHAUSA online is an essential step in communicating your medical preferences effectively. This guide will provide you with clear instructions to ensure the form accurately reflects your wishes regarding life-sustaining treatment.
Follow the steps to successfully complete the form online.
- Press the ‘Get Form’ button to obtain the Sample POLST Form - CHAUSA and open it for editing.
- Enter your personal information in the appropriate fields, including your last name, first name, middle initial, and date of birth. This information is necessary for identifying your specific medical orders.
- In section A, check the preferred option regarding cardiopulmonary resuscitation (CPR). You can choose to either resuscitate or elect for Do Not Attempt Resuscitation (DNR).
- In section B, select the type of medical interventions you wish to utilize if you are breathing and have a pulse. Choose from options such as comfort measures only, limited additional interventions, or full treatment.
- Proceed to section C where you decide on the use of antibiotics. Indicate your preference by checking the appropriate box: no antibiotics, limited use, or full use.
- In section D, determine your preference regarding artificially administered nutrition. Select from options including no artificial nutrition, a defined trial period, or long-term use.
- Add any additional orders in the provided sections if necessary to specify your wishes further.
- Fill in the summary of your medical condition and the signatures section. Ensure you provide the name of the healthcare provider preparing the form and the relevant contact details.
- Review the document for accuracy. Once complete, you can choose to save your changes, download a copy, print it, or share it with relevant individuals.
Take control of your healthcare decisions by completing the Sample POLST Form - CHAUSA online today.
POLST is a specific form that outlines your medical treatment preferences, particularly for individuals with serious illnesses or those nearing end-of-life. Advance care planning, on the other hand, encompasses the broader process of discussing and documenting your healthcare wishes, which may include various documents like advance directives. While advance care planning sets the stage for your preferences, a POLST form translates those preferences into actionable medical orders. Utilizing a Sample POLST Form - CHAUSA can significantly enhance your advance care planning process.
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