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DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE DNR DO-NOT-RESUSCITATE.

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The Physician Orders for Life Sustaining Treatment (POLST) form is a written medical order from a physician, nurse practitioner or physician assistant that helps give people with serious illnesses more control over their own care by specifying the types of medical treatment they want to receive during serious illness.

Because the POLST form is a medical order, emergency medical personnel are required to follow its instructions regarding CPR and other emergency medical care. The POLST form is printed on bright pink paper so it will be easily recognizable by all health care personnel.

An advance directive is a direction from the patient, not a medical order. In contrast, a POLST form consists of a set of medical orders that applies to a limited population of patients and addresses a limited number of critical medical decisions.

Generally, yes, so long as it is valid (with required signatures and dates). Check with your state contact to confirm (look up at .polst.org/map; click on your state).

Photocopies and FAXes of signed POLST forms are legal and valid. A copy should be retained in patient's medical record, on Ultra Pink paper when possible.

The POLST is generally a one page, two-sided uniquely identifiable form. It is printed on brightly colored heavy paper – fluorescent pink, bright yellow, or lime green. It is placed in the front of a patient's medical chart and accompanies the patient when hospitalized, transferred to another facility or discharged.

Print BOTH pages as a double-sided form on a single sheet of paper. Health care providers should complete this form only after a conversation with their patient or the patient's representative.

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.

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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