Get the free Physician Orders for Life - Sustaining Treatment (POLST) Form - wsma

Physician Orders for Life-Sustaining Treatment (POST) Form provider is not yet aware of, or needs more information about the POST form, please have them contact the Washington State Medical Association

How to fill out physician orders for life

How to fill out physician orders for life:

1. Begin by obtaining a physician orders for life form (POLST) from your healthcare provider or downloading it from a reliable source.
2. Carefully read and understand the instructions provided on the form. It is crucial to comprehend the purpose and significance of each section.
3. Fill in your personal information accurately, including your full name, date of birth, and current address. This information helps healthcare providers identify you and ensure the POLST form applies to you.
4. Provide essential contact information, such as phone numbers for your primary care physician, emergency contact, and healthcare proxy if applicable.
5. Discuss your preferences and goals of care with your healthcare provider. This conversation is crucial in defining your wishes regarding life-sustaining treatments in different medical situations. Your healthcare provider will help you complete the appropriate sections of the POLST form based on these preferences.
6. Decide on the level of medical intervention you desire in different scenarios, such as during cardiopulmonary resuscitation (CPR), intubation, or artificial nutrition. Indicate your choices by checking the appropriate boxes or writing in clear instructions, ensuring they align with your preferences.
7. Sign and date the POLST form. Some jurisdictions may require a witness signature or notarization, so ensure compliance with local regulations.
8. Copies of the completed POLST form should be distributed as follows: keep a copy for yourself, provide one to your primary care physician, share with your emergency contact, and if applicable, provide one to your healthcare proxy and any healthcare facility where you regularly receive treatment.
9. Review your POLST form periodically to ensure it reflects your current wishes. It is recommended to review and update the form annually or as your medical condition or preferences change.

Who needs physician orders for life:

1. Individuals with advanced chronic or terminal illnesses should consider having a physician orders for life form. This includes conditions like end-stage heart failure, advanced cancer, chronic obstructive pulmonary disease (COPD), or neurodegenerative diseases.
2. Elderly individuals who may have multiple chronic medical conditions and desire to document their treatment preferences.
3. Individuals who anticipate a decline in their health or may face critical medical decisions in the near future.
4. People seeking to ensure that their healthcare preferences are known and respected, especially when they may not have the capacity to communicate their wishes.
5. Those who want to avoid unwanted or overly burdensome medical interventions that may not align with their values or quality of life goals.
6. Healthcare professionals, including doctors, nurses, and healthcare facility staff, who provide care for individuals with serious illnesses or in palliative care settings, should also familiarize themselves with physician orders for life.

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What is physician orders for life?

Physician Orders for Life Sustaining Treatment (POLST) is a form that outlines a patient's medical treatment preferences for end-of-life care.

Who is required to file physician orders for life?

Physicians, physician assistants, or nurse practitioners are typically responsible for completing and filing the physician orders for life form on behalf of the patient.

How to fill out physician orders for life?

The form should be completed by a healthcare provider in consultation with the patient or their legal representative, and it should accurately reflect the patient's wishes for medical treatment.

What is the purpose of physician orders for life?

The purpose of physician orders for life is to ensure that a patient's preferences for end-of-life care are documented and honored by healthcare providers.

What information must be reported on physician orders for life?

Information such as preferences for CPR, intubation, antibiotics, and artificial nutrition should be reported on the physician orders for life form.