Practitioner Orders for Life-Sustaining Treatment (POLST)

Practitioner Orders for Life Sustaining Treatment

The Practitioner Orders for Life Sustaining Treatment (POLST) form enables patients to indicate their preferences regarding life-sustaining treatment. This form, signed by a patient's attending physician, advanced practice nurse or physician’s assistant, provides instructions for health care personnel to follow for a range of life-prolonging interventions. This form becomes part of a patient's medical records, following the patient from one healthcare setting to another, including hospital, nursing home or hospice.

Pursuant to P.L. 2011, c. 145, the Institute for Quality & Patient Safety Organization was designated as the Lead Agency for Physician Orders for Life-Sustaining Treatment Act.

View the New POLST Form

English | English (Green) | Hindi | Korean | Russian | Spanish | Vietnamese |

Last Reviewed: 1/31/2022