Physician Orders for Life-Sustaining Treatment (POLST)

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Physician Orders for Life-Sustaining Treatment (POLST) is a form that gives seriously-ill patients more control over their end-of-life care, including medical treatment, extraordinary measures (such as a ventilator or feeding tube) and CPR. Printed on bright pink paper, and signed by both a doctor and patient, POLST can prevent unwanted or ineffective treatments, reduce patient and family suffering, and ensure that a patient's wishes are honored.

NOTE: The form should be copied/printed on 65# Cover Ultra Pink card stock.

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