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Updated to reflect the recommendations by the California POLST Task Force effective 01/01/16.
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POLST (Physician Orders for Life-Sustaining Treatment) medical orders provide greater control over end-of-life care by documenting a person’s preferences regarding specific treatments and key medical decisions. POLST medical orders have already been adopted by the state of California and many other states are developing similar programs.POLST is different from an Advance Health Care Directive. The POLST Form for California should be completed as part of a discussion with a patient or their health care decision maker and a physician. The completed POLST should be retained by the patient or their health care decision maker and can be revised or voided by the responsible party at any time.A Ultra Pink POLST for California blank paper version is available for health care providers (LTC, assisted living, home care and hospice) to copy the POLST Form for California onto and meets the California “brightly colored” paper requirement.Side one of the MED-PASS POLST Form for California documents:
Side two of the MED-PASS POLST Form for California provides directions for:
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