Last updated on Mar 6, 2026
WA Physician Orders for Life-Sustaining Treatment (POLST) 2017 free printable template
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The POLST Form is a medical consent document used by patients and healthcare providers to outline life-sustaining treatment preferences and goals.
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Who needs WA Physician Orders for Life-Sustaining Treatment POLST?
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WA Physician Orders for Life-Sustaining Treatment POLST is needed by:
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Patients with serious health conditions
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Legal surrogates for patients
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Healthcare providers including physicians, ARNPs, and PA-Cs
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Caregivers involved in patient care decisions
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Hospitals and healthcare facilities in Washington State
Overview of the POLST Form
The POLST form, or Physician Orders for Life-Sustaining Treatment, is a crucial medical consent document utilized in Washington state. It provides essential directives regarding patients' preferences for life-sustaining treatment options. Understanding these preferences is vital for ensuring that healthcare decisions align with the values and desires of patients facing serious health conditions.
Purpose and Benefits of the POLST Form
The POLST form serves as a vital tool for both patients and healthcare providers. It plays an essential role in guiding medical treatment, clearly reflecting patient preferences and medical conditions. Patients benefit significantly from this form, as it ensures their treatment wishes are recognized and respected by healthcare professionals.
Key Features of the POLST Form
The POLST form encompasses several key components designed to facilitate clear communication about medical treatment preferences. Important sections include options for CPR preferences, non-emergency treatment preferences, and other medical orders. Signatures from both healthcare providers and the patient or their surrogate are necessary to validate the form.
Who Should Complete the POLST Form?
Understanding who should complete the POLST form is essential for its effective use. This document can be signed by healthcare providers such as Physicians, ARNPS, or PA-Cs, in conjunction with patients or their legal surrogates. Ideal candidates for utilizing the POLST form are typically those with serious health conditions who want their treatment preferences documented clearly.
How to Fill Out the POLST Form Online
Filling out the POLST form online using pdfFiller is straightforward and user-friendly. Follow these steps to ensure accurate completion:
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Access the POLST form on the pdfFiller website.
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Input required patient information into the designated fields.
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Select appropriate options for treatment preferences.
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Review the form for any common errors before submission.
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Securely sign the form using pdfFiller's digital signature feature.
Submission and Use of the POLST Form
Proper submission and utilization of the POLST form are essential for its effectiveness. Healthcare providers should ensure that the completed form accompanies patients during transfers or discharges. Adhering to state-specific rules for the POLST form ensures compliance and recognition in healthcare settings.
Security and Compliance with the POLST Form
Security is paramount when handling the POLST form. Utilizing pdfFiller provides robust security measures to protect sensitive health information, including 256-bit encryption. This platform also complies with HIPAA and GDPR regulations, safeguarding the privacy of users and their health documents.
How pdfFiller Facilitates the Completion of the POLST Form
pdfFiller streamlines the process of completing and managing the POLST form. Users can take advantage of features such as text editing, annotations, and the ability to securely sign their documents online. This efficient platform encourages users to embrace a hassle-free experience when managing their healthcare forms.
Sample of a Completed POLST Form
A visual guide depicting a sample POLST form can significantly aid users in understanding how to accurately fill it out. This annotated example highlights common patient choices and preferences, providing clarity on how completed forms should appear.
Next Steps for Using Your POLST Form
Completing the POLST form accurately is crucial for effective communication in healthcare settings. With the user-friendly pdfFiller platform, individuals can easily begin the process of filling out their POLST form online, ensuring their medical preferences are well-documented and respected.
How to fill out the WA Physician Orders for Life-Sustaining Treatment POLST
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1.Access pdfFiller and search for the POLST Form in the form library.
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2.Once located, click on the form to open it in the editor.
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3.Review the sections of the form, including CPR preferences and medical interventions.
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4.Before starting, gather necessary information such as patient medical history and treatment preferences.
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5.Use the fillable fields to enter information precisely where indicated.
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6.Utilize checkboxes to indicate preferences clearly.
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7.After completing all sections, carefully review the information entered for any errors or omissions.
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8.Ensure that both the signing physician/ARNP/PA-C and the patient or legal surrogate can sign within the designated areas.
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9.Finalize the form by saving your progress frequently to avoid data loss.
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10.Once completed, download the document for printing or share it directly with healthcare providers through pdfFiller.
Who is eligible to use the POLST Form?
The POLST Form is designed for patients facing serious health conditions as well as their legal surrogates. It is applicable in Washington State and requires signatures from both a healthcare provider and the patient or their surrogate.
How often should the POLST Form be reviewed?
It is recommended that the POLST Form be reviewed periodically or whenever there is a significant change in the patient's health status to ensure that treatment preferences remain current and aligned with patient goals.
What information is required to complete the POLST Form?
You will need to provide the patient's medical history, specific treatment preferences, and names of the legal surrogates or health care providers signing the form to ensure all parties are informed and consenting.
Can the POLST Form be submitted electronically?
The POLST Form can be completed and submitted electronically through platforms like pdfFiller. Make sure to check with your healthcare provider on their submission preferences.
What are common mistakes to avoid when filling out the POLST Form?
Common mistakes include leaving fields blank, forgetting necessary signatures, and failing to ensure that the form accurately reflects the patient's wishes. Double-checking the form before submission can prevent issues.
What happens if the POLST Form is not properly signed?
If the POLST Form is not signed by both the required healthcare provider and the patient or their legal surrogate, it may not be considered valid and could lead to confusion regarding treatment decisions.
Are there any costs associated with using the POLST Form?
Typically, there are no direct costs for the POLST Form itself, but be mindful that healthcare providers may charge for consultations or to provide their signature on the form.
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