Get Ut R432-31 2019-2026

The UT R432-31 form, officially known as the Provider Order for Life-Sustaining Treatment (POLST), is essential for documenting a person's medical treatment preferences. This guide provides clear, step-by-step instructions for filling out the form online, tailoring the process to meet the needs of all users.

Follow the steps to complete the UT R432-31 form efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by filling in the patient's personal information, including their last name, first name, middle initial, date of birth, and the last four digits of their Social Security Number.
3. Enter the effective date of the order and the patient's complete address, including street, city, state, and zip code.
4. Provide the name and phone number of the medical provider responsible for the patient's care.
5. In section A, choose the preferred treatment options when the patient does not have a pulse or is not breathing. Options include 'Attempt to resuscitate,' 'Do not attempt resuscitation (DNR),' or 'I do not wish to express a preference.'
6. Proceed to section B, and select the desired medical interventions when the patient has a pulse and is breathing. Options include 'Full treatment,' 'Limited additional interventions,' 'Comfort measures,' or 'No preference.'
7. In section C, specify preferences regarding artificial nutrition. Choose from 'Trial period of artificial nutrition with feeding tube,' 'No artificial nutrition,' or 'I do not wish to express a preference.' Provide additional goals or a time period if applicable.
8. If there is an advance directive, indicate its status in section D. Specify if available and confirmed without conflicts, or if no advance directive exists.
9. Ensure all required signatures are completed. This includes the signature of the medical provider and, if the patient is a minor, obtain signatures from two different medical providers. Make sure to also sign where indicated as the person preparing the form.
10. After completing all sections, review the entire form for accuracy. You can then save changes, download, print, or share the completed form.

Complete your UT R432-31 form online to ensure your medical preferences are clearly documented.