Montana polst form pdf 2026

1. Click ‘Get Form’ to open the Montana POLST form in our editor.
2. Begin by entering the patient's first and last name, along with their date of birth. Ensure this information is accurate as it identifies the individual for whom the orders apply.
3. In Section A, select one option regarding Cardiopulmonary Resuscitation (CPR). Choose either 'Resuscitate (Full Code)' or 'Do Not Resuscitate (No Code)'. Only one box should be checked.
4. Proceed to Section B for Medical Interventions. Select one option that best describes the level of care desired if the patient has a pulse and is breathing. Options include Comfort Measures, Limited Additional Interventions, or Full Treatment.
5. In Section C, indicate preferences for Artificial Fluids and Nutrition by selecting options for feeding tubes and IV fluids. You may select more than one option here.
6. Section D allows you to note any Advance Directives that exist. Specify if there are any additional documents like a Living Will.
7. Finally, ensure Section E is completed with signatures from both the patient or surrogate and the physician/APRN/PA. This section is crucial for validating the POLST form.

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