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  • Ma Molst Form 2013

Get Ma Molst Form 2013-2025

_______________ Health Care Agent Printed Name ___________________________________ Telephone Number ________________ Primary Care Provider Printed Name ________________________________ Telephone Number ________________ SEND THIS FORM WITH THE PATIENT AT ALL TIMES. HIPAA permits disclosure of MOLST to health care providers as necessary for treatment. Approved by DPH August 10, 2013 MOLST Form Page 1 of 2 Patient’s Name: ______________________ Patient’s DOB ___________ Medical Record # i.

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How to fill out the MA MOLST Form online

The Massachusetts Medical Orders for Life-Sustaining Treatment (MOLST) form is a crucial document that outlines a person's preferences regarding medical treatment during serious illness. This guide will provide a clear, step-by-step approach for filling out the MA MOLST form online, ensuring that users can navigate the process with confidence.

Follow the steps to fill out the MA MOLST Form accurately.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the patient's name in the designated area at the top of the form. This ensures that the medical orders are explicitly associated with the correct individual.
  3. Fill in the date of birth and the medical record number if applicable. Accurate identification is essential for effective treatment.
  4. In Section A, mark the appropriate circle based on the patient's wishes regarding cardiopulmonary resuscitation. Choose either 'Do Not Resuscitate' or 'Attempt Resuscitation'.
  5. In Section B, indicate the preferences for ventilation for a patient in respiratory distress. Select one option from the choices provided.
  6. In Section C, select the preferred course of action regarding transfer to the hospital under specific conditions.
  7. Ensure that Section D is completed with the appropriate signature from the patient or their representative, confirming that the form reflects their wishes.
  8. Complete Section E with the clinician's signature, confirming the accuracy of the discussions held with the signer in Section D.
  9. In Section F and Section G, specify patient preferences for other medically indicated treatments. Mark the appropriate circles and provide any additional treatment options as necessary.
  10. Finally, review all filled sections for completeness. Save any changes made, and utilize the options available to download, print, or share the completed form.

Start filling out the MA MOLST Form online today to ensure your medical preferences are documented.

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You can obtain a MA MOLST Form from various healthcare providers, including hospitals, physician offices, and home health agencies. Additionally, organizations focused on patient advocacy often provide information on how to acquire the form. If you need guidance or assistance, US Legal Forms offers accessible templates and resources to simplify the process of obtaining and completing your MOLST form.

While the MA MOLST Form may include a DNR order, it is not solely a DNR. The MOLST form encompasses broader medical treatment decisions. It allows individuals to indicate their preferences for various types of medical interventions, making it a more comprehensive tool compared to a DNR, which focuses only on resuscitation measures.

In Massachusetts, the MA MOLST Form remains valid until it is revoked or updated by the individual who signed it. This means that once someone completes and signs the MOLST, it stays effective as long as their healthcare wishes do not change. However, it is wise to review the form periodically, especially during significant life events or health changes, to ensure it reflects current wishes.

The MA MOLST Form, or Medical Orders for Life-Sustaining Treatment, differs from a Do Not Resuscitate (DNR) order in its scope and application. A DNR specifically instructs medical personnel not to perform CPR if a person stops breathing or their heart stops. In contrast, the MOLST form covers a range of treatment options, providing detailed preferences regarding care and interventions, which may include or exclude certain life-sustaining treatments.

Yes, similar to the MA MOLST Form, a POLST form can also be signed electronically, adhering to state regulations. Ensuring that the electronic signature complies with legal standards is vital for it to be recognized by healthcare providers. Platforms like USLegalForms can simplify the electronic signing process and help you manage your healthcare preferences effectively.

For the MA MOLST Form to be valid, it must be completed accurately and signed by both the patient and their physician. Additionally, the form should reflect the patient's preferences regarding life-sustaining treatments and should be dated. It is crucial that the form is easily accessible to healthcare providers in emergencies to ensure that your wishes are honored.

Yes, for the MA MOLST Form to be valid, a physician must sign it. This signature confirms that the physician has discussed the patient's treatment preferences and that they support the plans outlined in the form. A signature from a physician ensures that your wishes are recognized in medical situations and helps healthcare providers follow your directives.

The primary purpose of a MA MOLST Form is to ensure that your healthcare preferences are clearly communicated and respected in emergencies. It serves as a critical tool for individuals with serious medical conditions who may not be able to voice their wishes at the moment of treatment. By using a MA MOLST Form, you can alleviate the burden on your loved ones and healthcare providers during difficult times. Ultimately, this form empowers you to make informed choices about your care.

In most cases, a healthcare proxy cannot override a completed MA MOLST Form. The MOLST Form reflects your personal preferences regarding medical treatment, which should be honored even if a healthcare proxy is designated. However, it’s essential to communicate your wishes clearly to both your proxy and healthcare providers. Doing so ensures that everyone involved understands your decisions and respects your choices when the time comes.

In Massachusetts, anyone with a serious health condition can initiate the completion of a MA MOLST Form. This includes patients with chronic illnesses or those facing end-of-life decisions. While healthcare providers typically help draft the form, it is crucial that you actively participate in the discussions about your medical wishes. This ensures that the form aligns with your personal values and beliefs.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232