Polst form hawaii 2026

1. Click ‘Get Form’ to open the POLST form in our editor.
2. Begin by entering the patient's First and Last Name, Date of Birth, and the Date Form Prepared in Section A. This information is crucial for identifying the patient.
3. In Section B, select one of the options regarding Cardiopulmonary Resuscitation (CPR). Choose between 'Attempt Resuscitation/CPR' or 'Do Not Attempt Resuscitation/DNAR' based on the patient's wishes.
4. Next, indicate the desired Medical Interventions by checking one option: 'Comfort Measures Only', 'Limited Additional Interventions', or 'Full Treatment'. Each option outlines different levels of care.
5. Proceed to Section C to specify preferences for Artificially Administered Nutrition. Choose from 'No artificial nutrition by tube', 'Long-term artificial nutrition by tube', or a defined trial period.
6. In Section D, ensure that signatures are obtained from both the Provider and the Patient or their Legally Authorized Representative. This validates the orders outlined in the form.

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