Download the master copy POLST form for print - wsma 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the patient’s personal information, including Last Name, First Name, Middle Initial, Date of Birth, and Gender. This section is crucial for identifying the individual.
3. In Section A, choose between 'DNAR/Do Not Attempt Resuscitation' or 'CPR/Attempt Resuscitation'. Make sure to check only one option that aligns with the patient's wishes.
4. Proceed to Section B to select medical interventions. Options include 'Comfort Measures Only', 'Limited Additional Interventions', or 'Full Treatment'. Each choice outlines different levels of care.
5. In Section C, ensure that all required signatures are obtained. This includes signatures from both the physician and the patient or their legal surrogate.
6. Finally, review all sections for completeness and accuracy before saving or printing the document. Ensure that any additional orders are clearly noted.

Start using our platform today to easily fill out and manage your POLST forms online for free!