Polst form hawaii 2026

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  1. Click ‘Get Form’ to open the POLST form in our editor.
  2. Begin by filling in the patient’s last name, first/middle name, and date of birth at the top of the form. This information is crucial for identifying the patient.
  3. In Section A, indicate the desired resuscitation preferences by checking the appropriate box. Options include 'Attempt Resuscitation' or 'Do Not Attempt Resuscitation.'
  4. Proceed to Section B to specify medical interventions. Choose between 'Comfort Measures Only,' 'Limited Additional Interventions,' or 'Full Treatment' based on the patient's wishes.
  5. In Section C, decide on artificial nutrition and hydration preferences. Indicate if food and liquid should be offered by mouth or if artificial nutrition is desired.
  6. Ensure that both the patient (or their legally authorized representative) and a licensed provider sign the form in the designated areas to validate it.

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Advance Directives: POLSTs give specific directions about treatments during an emergency if you cannot speak for yourself. However, POLSTs do not appoint someone to speak on your behalf (surrogate or health care agent) which Advance Directives generally do.
One difference between a POLST form and an advance directive is that the POLST form is designed to be actionable throughout an entire community. It is immediately recognizable and can be used by doctors and first responders (including paramedics, fire departments, police, emergency rooms, hospitals and nursing homes).
A POLST is more comprehensive than a Do Not Resuscitate order. A DNR is a stand-alone document that tells emergency medical personnel whether to perform CPR if your heart and breathing stop and you are unresponsive. A POLST includes your instructions about whether or not to perform CPR, but it doesnt stop there.
About the MOLST to POLST Transition The MOLST form is still valid and should be used to document patients wishes until further notice. Previous POLST test sites should continue to use the POLST in paper format, and should be considered valid by EMS and other healthcare professionals.
An advance directive is a direction from the patient, not a medical order. In contrast, a POLST form consists of a set of medical orders that applies to a limited population of patients and addresses a limited number of critical medical decisions.

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The Physician Orders for Life Sustaining Treatment (POLST) form is a written medical order from a physician, nurse practitioner or physician assistant that helps give people with serious illnesses more control over their own care by specifying the types of medical treatment they want to receive during serious illness.

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