Get Ca Emsa 111 B 2009-2026

The CA EMSA 111 B form, also known as the Physician Orders for Life-Sustaining Treatment (POLST), is a crucial document for individuals to communicate their medical treatment preferences. This guide provides clear, step-by-step instructions for filling out the form online, ensuring your choices are accurately represented and respected.

Follow the steps to complete the CA EMSA 111 B online

1. Press the ‘Get Form’ button to access the CA EMSA 111 B and open it in your preferred online editor.
2. Begin by entering the last name and first name of the individual for whom the POLST is being completed. This should also include the middle name if applicable.
3. Indicate the date of birth of the individual. This is important for identifying the correct medical history and context.
4. Select one option from Section A regarding cardiopulmonary resuscitation (CPR). Choose between 'Attempt Resuscitation/CPR' or 'Do Not Attempt Resuscitation/DNR (Allow Natural Death).' Ensure that you understand the implications of both choices.
5. Move to Section B and choose the preferred medical interventions based on the individual's needs. Options include: 'Comfort Measures Only,' 'Limited Additional Interventions,' or 'Full Treatment.' Make sure to read the descriptions carefully to ensure informed decision-making.
6. In Section C, indicate preferences regarding artificially administered nutrition. Options include: 'No artificial nutrition by tube,' 'Defined trial period of artificial nutrition by tube,' or 'Long-term artificial nutrition by tube.'
7. Complete Section D by gathering necessary signatures. The physician must sign to confirm that the orders align with the individual's medical condition and preferences. Additionally, ensure the patient's decision-maker or conservator also signs the form.
8. Finally, review the completed form to ensure all sections are filled out correctly. Once satisfied, you can download, print, save the form, or share it as needed.

Complete your CA EMSA 111 B form online today to ensure your healthcare preferences are documented and respected.