Get Polst Form

The Physician Orders for Life-Sustaining Treatment (POLST) form is a crucial document for communicating a person's medical treatment preferences. This guide will help you navigate the process of filling out the POLST form online, ensuring that you accurately capture the necessary information.

Follow the steps to complete the Polst Form online:

1. Click 'Get Form' button to access the POLST form and open it in the editor.
2. Begin by entering the patient's full name, including last name, first name, and middle name in the designated fields. Also, input the date of birth and optional medical record number.
3. Next, address the Cardiopulmonary Resuscitation (CPR) preferences. Choose between 'Attempt Resuscitation/CPR' or 'Do Not Attempt Resuscitation/DNR' based on the patient's wishes.
4. Proceed to the Medical Interventions section. Select one option: 'Comfort Measures Only,' 'Limited Additional Interventions,' or 'Full Treatment.' Include any additional orders if necessary.
5. In the Artificially Administered Nutrition section, choose the appropriate option regarding the administration of nutrition, and include any additional orders as applicable.
6. Complete the Information and Signatures section. Indicate whether the patient or legally recognized decision-maker was involved in the discussion. Have the physician print their name, license number, and sign.
7. Finally, save the changes, download the form, and ensure it is printed on the specified Ultra Pink card stock paper if possible. Be ready to share the form with relevant healthcare providers when necessary.

Start completing your POLST form online today to ensure your or your loved one’s medical preferences are clearly communicated.