Understanding POLST and Advance Directives
This file contains crucial information about Physician Orders for Life-Sustaining Treatment (POLST), including how to fill out the form, its importance, and instructions for healthcare providers. It is essential for individuals with serious illnesses or advanced care planning needs. The document respects patient preferences and helps communicate treatment orders to healthcare professionals.
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How do I fill this out?
To fill out the POLST form, first ensure that you understand the patient's current medical condition and preferences. Consult with a healthcare provider to complete the necessary sections accurately. Once filled, the form should be reviewed and signed by both the healthcare professional and the patient or their authorized surrogate.

How to fill out the Understanding POLST and Advance Directives?
1
Discuss the patient's preferences and medical condition with a healthcare provider.
2
Complete the relevant sections of the POLST form.
3
Ensure signatures are obtained from the healthcare professional and the authorized surrogate.
4
Review the form for accuracy and completeness.
5
Deliver the original form with the patient during any transfers or discharges.
Who needs the Understanding POLST and Advance Directives?
1
Patients with terminal illnesses need this form to communicate their treatment preferences effectively.
2
Family members or surrogates of incapacitated individuals need it to ensure the patient's wishes are respected.
3
Healthcare providers require this form to guide medical decisions according to the patient's preferences.
4
Care facilities need it to maintain consistent treatment principles for incoming patients.
5
Legal representatives may need this form to have documented consent for healthcare decisions.
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Edit your POLST PDF on PrintFriendly by selecting the 'Edit' option and making necessary adjustments. You can easily add text, modify existing information, or correct any errors. Once satisfied with your changes, download the updated PDF for submission.
1
Open the POLST PDF in PrintFriendly.
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Select the 'Edit' option from the menu.
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Make necessary changes to the form fields.
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Once edits are complete, review the document for any errors.
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Download the finalized PDF for submission.

What are the instructions for submitting this form?
To submit the POLST form, please ensure that it is signed by the healthcare provider and the patient or their legal surrogate. You may fax the completed document to the appropriate healthcare facility or email it to the designated contact. Additionally, it is essential to keep a physical copy for your records and carry it with you during medical appointments or transitions.
What are the important dates for this form in 2024 and 2025?
Specific important dates for the POLST form will vary by state. Generally, it is recommended to review the form annually or after any substantial change in health status. Keeping the form updated ensures that it reflects the current wishes and medical condition of the patient.

What is the purpose of this form?
The purpose of the POLST form is to provide clear medical orders that reflect a patient's treatment preferences in emergencies. It serves as a communication tool between patients, families, and healthcare providers, ensuring that everyone involved understands the patient's wishes. By filling out the POLST form, individuals can take control of their healthcare decisions and ensure that their preferences are respected.

Tell me about this form and its components and fields line-by-line.

- 1. Personal Information: Includes the patient's name, date of birth, and last four digits of SSN.
- 2. Medical Conditions/Goals: Outlines the patient's current medical conditions and desired treatment goals.
- 3. CPR Preferences: Indicates whether the patient desires resuscitation or DNAR.
- 4. Medical Interventions: Describes the level of medical interventions the patient wishes to receive.
- 5. Signatures: Verifies that the orders reflect the patient's preferences and require signatures from involved parties.
What happens if I fail to submit this form?
Failing to submit the POLST form may lead to a lack of clarity in the patient's treatment preferences, which can result in unwanted or inappropriate medical interventions.
- Miscommunication with Healthcare Providers: Without the form, healthcare providers may not be aware of the patient's wishes, leading to unnecessary treatments.
- Potential Legal Issues: Not having a documented form can result in legal complications regarding treatment decisions.
- Patient Distress: The absence of clear directives may result in distress for the patient and their family during critical medical situations.
How do I know when to use this form?

- 1. End-of-Life Planning: Patients may use this form to specify their wishes regarding life-sustaining treatments.
- 2. Medical Emergencies: During emergencies, the POLST provides immediate guidance for healthcare providers.
- 3. Transitioning Care: Essential when a patient moves between healthcare settings to ensure wishes are respected.
Frequently Asked Questions
What is the POLST form?
The POLST form is a medical order that outlines a patient's treatment preferences during a medical emergency.
Who should fill out the POLST form?
The form should be completed by a healthcare provider in conjunction with the patient or their surrogate.
Can I edit the POLST form?
Yes, you can easily edit the POLST PDF using PrintFriendly's PDF editor.
How do I submit the POLST form?
You can submit the completed POLST form to your healthcare provider or carry it with you during medical transfers.
Is the POLST form legally binding?
Yes, signed POLST forms are legally binding in most states.
What if I want to change my treatment preferences?
You can void the existing POLST form and complete a new one with your updated preferences.
How do I share my POLST form with family members?
You can share the POLST PDF easily through PrintFriendly's sharing options.
What if the POLST form is incomplete?
Any incomplete sections default to full treatment for that area as per medical guidelines.
Are photocopies of the POLST form valid?
Yes, photocopies and faxes of signed POLST forms are considered legal and valid.
When should I review my POLST form?
You should review the POLST form whenever there is a change in health status or transfer between care settings.
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