This form is a Declaration Relating To Use Of Life Sustaining Procedures for the State of Alaska, and allows an individual to declare whether or not such procedures will be used to prolong his/her life. It also contains provisions for the donation of specific body parts in the event of death. This document must be witnessed and properly acknowledged.
Alaska Declaration relating to use of life sustaining procedures - Do Not Resuscitate - DNR - Optional Donation of tissues
State:
Alaska
Control #:
AK-02005
Format:
Word;
Rich Text
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How to fill out Alaska Declaration Relating To Use Of Life Sustaining Procedures - Do Not Resuscitate - DNR - Optional Donation Of Tissues?
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FAQ
A POLST form is a legal document for people with an advanced progressive or terminal illnesses and specifies the type of care a person would like in an emergency medical situation.
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.
Anyone who has a chronic or life-limiting illness or anyone with advanced age should consider having a POLST document.
The POLST form is completed by a patient's physician (or by someone who has undergone special training about POLST and who works with the patient's physician) in conjunction with thorough conversation with the patient regarding the patient's current and future health conditions and treatment preferences.
How to Order the National POLST Form. Visit your program website or reach out to your program contact to order POLST forms (www.polst.org/map). Forms are not available to individuals since they are medical orders that should be completed by providers.
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.
The California POLST form is valid in California. If you are traveling to another state, it is a good idea to take both your Advance Directive and your POLST form with you. Both documents, even if not legally binding, will help health care providers know your wishes. How can I find out more about POLST?
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.