Get the free Montana POLST form. Montana POLST form - dphhs mt
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September2019Previouslycompleteddocumentsarevaliduntilrevisedorrevoked.SENDORIGINALFORMWITHPERSONWHENEVERTRANSFERREDORDISCHARGED HIPAAPERMITSDISCLOSUREOFTHISINFORMATIONTOOTHERHEALTHCAREPROFESSIONALSASNECESSARY
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How to fill out montana polst form montana
How to fill out montana polst form montana
01
To fill out the Montana POLST form, follow these steps:
02
Obtain the official Montana POLST form from a healthcare provider or online.
03
Start by providing your personal information, including your full name, date of birth, and contact information.
04
Proceed to fill out the medical decision-making section. This includes specifying your preferences regarding life-sustaining treatment options such as CPR, intubation, and artificial nutrition.
05
Indicate your preferred level of medical intervention, such as full treatment, selective treatment, or comfort-focused treatment.
06
If you have any specific instructions or preferences regarding your healthcare, you can include them in the additional instructions section.
07
Once you have completed the form, review it carefully to ensure all information is accurate and complete.
08
Sign and date the Montana POLST form.
09
Make copies of the form for your records and provide copies to your healthcare proxy, family members, and healthcare providers.
10
Remember to update the form if your preferences or medical condition changes in the future.
Who needs montana polst form montana?
01
The Montana POLST form is designed for individuals with serious, advanced illnesses or frailty who wish to document their preferences for medical treatment. This form is particularly relevant for individuals in the following situations:
02
- Those with terminal conditions who are not eligible for hospice or palliative care
03
- Individuals with chronic progressive conditions, such as advanced heart failure or advanced neurological disorders
04
- Those with a history of repeated hospitalizations or emergency room visits
05
- Frail elderly individuals with multiple chronic conditions
06
- Residents of long-term care facilities
07
- People who want to ensure their treatment preferences are respected and followed during medical emergencies.
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What is montana polst form montana?
The Montana Physician Orders for Life-Sustaining Treatment (POLST) form is a medical order form that outlines the types of medical treatment that a patient does or does not want during a medical emergency.
Who is required to file montana polst form montana?
The Montana POLST form is typically completed by a physician or other healthcare provider in consultation with the patient or their designated healthcare agent.
How to fill out montana polst form montana?
The form should be filled out by a healthcare provider based on discussions with the patient or their healthcare agent regarding their preferences for life-saving interventions.
What is the purpose of montana polst form montana?
The purpose of the Montana POLST form is to ensure that a patient's wishes regarding life-sustaining treatment are known and followed in emergency medical situations.
What information must be reported on montana polst form montana?
The form includes information about the patient's preferences for CPR, intubation, artificial nutrition, and other medical interventions.
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