MT Provider Orders for Life-Sustaining Treatment (POLST) 2026

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  1. Click ‘Get Form’ to open the MT Provider Orders for Life-Sustaining Treatment (POLST) in the editor.
  2. Begin by entering the patient's legal last name, first name, middle name, and date of birth in the designated fields.
  3. In Section A, select one box only regarding cardiopulmonary resuscitation (CPR): either 'YES CPR' or 'NO CPR'. Ensure you understand the implications of your choice.
  4. Proceed to Section B and choose one treatment option: 'Full Treatment', 'Selective Treatment', or 'Comfort-focused Treatment'. Each option has specific instructions regarding medical interventions.
  5. In Section C, indicate preferences for artificially administered nutrition by selecting one of the options provided.
  6. Ensure all necessary signatures are obtained from the patient or their legal decision-maker and healthcare provider. This is mandatory for validation.

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See more MT Provider Orders for Life-Sustaining Treatment (POLST) versions

We've got more versions of the MT Provider Orders for Life-Sustaining Treatment (POLST) form. Select the right MT Provider Orders for Life-Sustaining Treatment (POLST) version from the list and start editing it straight away!
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2024 4.8 Satisfied (37 Votes)
2019 4.8 Satisfied (87 Votes)
2014 4.4 Satisfied (140 Votes)
2009 4.3 Satisfied (50 Votes)
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