Physician Orders for Life-Sustaining Treatment (POLST)

If you or someone you love is seriously ill, you may want to make decisions about life-sustaining treatment—before they're no longer able to do so. Once these wishes have been discussed with your physician, they can be transformed into actual physician orders called POLST.

The POLST form can provide security for you and your physician that your wishes will be carried out. The form will remain with you if you are transported between care settings, regardless of whether you are in the hospital, at home or in a long-term care facility. There is no other form that streamlines the process in this way.

The POLST form must be signed by both the patient and the attending physician, nurse practitioner or physician assistant-certified. The attending physician, ARNP or PA-C that signs the form assumes full responsibility for its accuracy.

What are my options for life-sustaining treatment?

You have the power to determine the kind of treatments you want to receive and the kind of treatments you want to avoid. To help you understand your options, visit the new Honoring Choices Pacific Northwest website for information that will help you begin these conversations with your family and health care professionals.

How is the form used?

POLST form In a home, or home-care setting, the bright green POLST form should be located in a prominent location. It will be recognized by emergency personnel as orders to be followed. In a health care facility, the form should be the first document in the clinical record. It should be recognized as a set of physician orders, to be implemented as any physicians orders would.

How is the form transferred from one setting to another?

Your completed and signed POLST form is a physician order form that will remain with you if you are transported between care settings, regardless of whether you are in the hospital, at home or in a long-term care facility. The institution may wish to keep a duplicated copy in the permanent medical record upon discharge.

If I have a POLST form, do I need an advance directive, too?

We encourage everyone to have an advance directive, like a durable power of attorney for health care and/or health care directive (also known as a living will). While advance directives are often very helpful in determining end-of-life decisions, they are not required or necessary for having a POLST form.

You may obtain more information about advance directives from your physician, your health insurance provider, or here.

How to order POLST forms and patient brochures

Patients are encouraged to ask their physicians for the form, but may also obtain a form (and/or the patient brochure) by sending a self-addressed, stamped envelope to WSMA, Attn: POLST, 2001 Sixth Avenue, Suite 2700, Seattle, WA 98121. Contact your attending physician's office and make an appointment to discuss the form and your wishes regarding life-sustaining treatment.