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Click ‘Get Form’ to open the POLST Form in the editor.
Begin by filling in your personal information in Section A. Enter your last name, first name, middle initial, and date of birth. Ensure that you also provide the name and phone number of your primary medical care provider.
In Section B, check one option regarding cardiopulmonary resuscitation (CPR). Choose 'Attempt Resuscitation' if you want full treatment or 'Do Not Attempt Resuscitation' if you prefer comfort-focused care.
Proceed to Section C to document discussions about your treatment preferences. Check all applicable boxes indicating who participated in the discussion and provide a signature along with your printed name and relationship.
Finally, Section D requires the signature of a physician or advanced practice registered nurse (APRN) confirming that the orders reflect your current medical condition and preferences. Ensure all required fields are completed before saving.

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Versions	Form popularity	Fillable & printable
2017	4.7 Satisfied (44 Votes)
2014	4.9 Satisfied (36 Votes)

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Can I sign my minnesota polst pdf electronically?

As outlined by eSignature regulations, documents signed electronically have the same validity as those approved with pen and paper. You can eSign almost any business and personal documentation. Four types of paperwork still call for wet signatures only - wills and testamentary trusts, court orders and other court papers, state statutes regulating divorce, adoption, or other family law, and notice of cancellation of utility services. If you follow the guidelines and utilize a safe and compliant software solution, like DocHub, you can eSign your minnesota polst pdf without printing it.

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What does POLST form stand for?

How to Order the National POLST Form. Visit your program website or docHub out to your program contact to order POLST forms. Forms are not available to individuals since they are medical orders that should be completed by providers.

What is the difference between a POLST and a DNR?

The POLST form is completed by a patients physician (or by someone who has undergone special training about POLST and who works with the patients physician) in conjunction with thorough conversation with the patient regarding the patients current and future health conditions and treatment preferences.

Is a DNR the same as a POLST?

You also maintain the ability to revoke the DNR at any time, as long as you have the capacity to make medical decisions. It is important to note that a power of attorney could revoke the DNR if they believe it best while you are incapacitated.

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