Download the California POLST Form and Informational Cover Sheet IMPORTANT: The POLST form should be completed by a medical provider during a good conversation between the patient and their …

Printed on bright pink paper, and signed by a patient or their legally recognized decision-maker and physician, nurse practitioner, or physician assistant, POLST can prevent unwanted or ineffective …

POLST is a form that clearly states what kinds of medical treatment patients want and don’t want. Printed on bright pink paper, and signed by both a patient and physician, nurse practitioner, or …

*Form versions with effective dates of 1/1/2009, 4/1/2011,10/1/2014 or 01/01/2016 are also valid

o follow its instructions regarding CPR and other emergency medical care. The POLST form is printed on bright pink pa r so it is easy to recognize, but photocopies are also considered or in writing. If you …

Download the California POLST form. When you purchase your POLST forms through Med-Pass, you are supporting the Coalition for Compassionate Care of California. Thank you!

This page is left intentionally blank. ... *Las versiones de los formularios con fechas de vigencia el 1/1/2009, 4/1/2011 o 10/1/2014 también son válidas. CA POLST Form – Spanish

This guide walks healthcare providers through the most commonly used phrases in assisting a patient and family through conversations about the POLST form. The guide includes phrases and questions …

Produced on a distinctive bright pink form and signed by both the doctor and patient, POLST specifies the types of medical treatment that a patient wishes to receive towards the end of life.

What happens to my POLST form after it is completed and signed? The original POLST form, on bright pink paper, stays with you at all times. • In a hospital, nursing home, or assisted living facility, the …