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  • Wa Physician Orders For Life-sustaining Treatment (polst) 2021

Get Wa Physician Orders For Life-sustaining Treatment (polst) 2021-2025

L order. It must be completed with a medical professional. Completing a POLST is always voluntary. IMPORTANT: See page 2 for complete instructions. MEDICAL CONDITIONS / INDIVIDUAL GOALS: A CHECK ONE B CHECK ONE C AGENCY INFO / PHONE (if applicable) Use of Cardiopulmonary Resuscitation (CPR): When the individual has NO pulse and is not breathing. YES Attempt Resuscitation / CPR (choose FULL TREATMENT in Section B) NO Do Not Attempt Resuscitation (DNAR) / Allow Natural Death When not.

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How to fill out the WA Physician Orders For Life-Sustaining Treatment (POLST) online

The Washington Physician Orders For Life-Sustaining Treatment (POLST) is a critical document that outlines an individual's preferences for medical treatment. This guide provides step-by-step instructions to help you navigate the online form effectively.

Follow the steps to complete the POLST form with ease.

  1. Press the ‘Get Form’ button to access the POLST form and open it in your selected editing platform.
  2. Fill in your last name, first name, middle name or initial, and date of birth in the designated fields.
  3. Optionally, specify your gender and pronouns, if comfortable doing so.
  4. Review the guidelines indicating that completing a POLST is voluntary and that it should be done with a medical professional.
  5. In 'Use of Cardiopulmonary Resuscitation (CPR)', select either 'Yes' to attempt resuscitation or 'No' to do not attempt resuscitation based on your preferences.
  6. Proceed to 'Level of Medical Interventions' and choose from the three options: Full Treatment, Selective Treatment, or Comfort-Focused Treatment, according to your healthcare goals.
  7. In the section for Additional Orders, make any requests for specific treatments like blood products or dialysis if applicable.
  8. If a legal medical decision maker is completing the form on behalf of an individual, they must provide their signature, print their name, and indicate their relationship to the individual.
  9. Ensure the form is signed by the required healthcare professional (MD/DO/ARNP/PA-C) along with the individual's signature or their legal medical decision maker.
  10. Once all fields are completed and verified, you can save changes, download, print, or share the form as needed.

Complete your documents online to ensure your healthcare preferences are honored.

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Must pink paper be used? Faxed copies and photocopies are valid. Ultra Pink paper is preferred and used to distinguish the form from other forms in the patient's medical record; however, the form will be honored on any color paper. Is the POLST form available in other languages?

The DNR guides Emergency Medical Service (EMS) providers and can give EMS permission not to perform cardiopulmonary resuscitation (CPR), whereas a POLST might include a DNR instruction regarding CPR, but provides more instructions regarding additional medical interventions.

Yes, the POLST can be modified or revoked by a patient, verbally or in writing, at any time. Changes may also be made by a physician, or requested by a patient's decisionmaker, based on new information or changes in the patient's condition. When should a patient's POLST form be reviewed?

The only requirement for a POLST form to be legally binding is for it to be signed by the patient or a representative and the patient's legal healthcare representative.

When should a POLST form be reviewed? As a clinical matter, a patient's POLST form should be reviewed periodically and updated if: The patient is transferred from one care setting or care level to another (including upon admission or at discharge); There is a substantial change in the patient's health status; or.

And, importantly, POLST forms do not expire meaning patients may be held to their choices many years after their preferences have changed. 3.

In the state of Washington, the POLST form is a portable physician order sheet that enables any individual with an advanced life-limiting illness to effectively communicate his or her wishes to limit life-sustaining medical treatment in a variety of health care settings, including the outpatient setting (Washington ...

A POLST form is a medical order that tells emergency health care professionals what to do during a medical crisis where the patient cannot speak for him or herself.

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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