Edit, Download, and Sign the California POLST Physician Orders for Treatment
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How do I fill this out?
To fill out the POLST form, you need to have a discussion with a healthcare provider. The provider will guide you in documenting your treatment preferences. Ensure that the form is signed by both you and your physician.
How to fill out the California POLST Physician Orders for Treatment?
1
Discuss your treatment preferences with your healthcare provider.
2
Fill out the POLST form specifying your wishes for end-of-life care.
3
Both the patient and physician must sign the POLST form.
4
Keep the original POLST form with you at all times.
5
Review the POLST regularly to ensure it reflects your current wishes.
Who needs the California POLST Physician Orders for Treatment?
1
Seriously ill patients who want to specify their treatment preferences.
2
Patients with terminal illnesses needing clear directives for healthcare providers.
3
Families of patients who wish to ensure their loved one's wishes are followed.
4
Healthcare providers who need guidance on patient care during end-of-life situations.
5
Legal guardians or decision-makers for patients who are unable to communicate.
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You can edit this PDF on PrintFriendly by opening the document in our editor. Modify any sections as needed to reflect your specific treatment preferences. Once you're satisfied with your edits, you can download the updated document.
1
Open the POLST form in PrintFriendly's editor.
2
Use the editing tools to make necessary changes to the document.
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Review your changes for accuracy and completeness.
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Share or print your modified POLST form as needed.
What are the instructions for submitting this form?
Submit the completed POLST form to your healthcare provider or hospital where you receive care. It’s important that your medical team has the most current version of your POLST on file. To ensure that the POLST is properly integrated into your health records, consider discussing the submission process with your healthcare provider directly.
What are the important dates for this form in 2024 and 2025?
California POLST Legislation (AB 3000) was authorized effective January 1, 2009. The details of this form remain essential for planning future healthcare matters. Make sure to stay informed about updates.
What is the purpose of this form?
The California POLST form is designed to ensure that patients receive the medical treatments they desire at the end of life. This form serves as a legal document that outlines a patient's treatment preferences, empowering them even in serious health conditions. By communicating these preferences to healthcare providers, POLST helps reduce unnecessary suffering and ensures patient wishes are honored.
Tell me about this form and its components and fields line-by-line.
- 1. Cardiopulmonary Resuscitation (CPR): Indicates whether the patient wishes to receive CPR or not.
- 2. Antibiotics and IV Fluids: Specifies preferences regarding the use of antibiotics and intravenous fluids during treatment.
- 3. Intubation and Mechanical Ventilation: Documents whether the patient consents to intubation and mechanical support.
- 4. Artificial Nutrition: Outlines the patient's wishes regarding artificial nutrition and hydration.
What happens if I fail to submit this form?
Failing to submit the POLST form could lead to unintended medical treatments that are not in line with the patient's wishes. This can cause unnecessary suffering for the patient and distress for their family. It's crucial to ensure that the form is properly filled out and submitted.
- Unwanted Treatments: Patients may receive interventions they do not want.
- Family Misunderstanding: Family members may struggle with treatment decisions without clear directives.
- Healthcare Provider Confusion: Providers may not be aware of the patient's wishes leading to inappropriate care.
How do I know when to use this form?
- 1. Serious Illness: Used for patients diagnosed with life-limiting conditions.
- 2. End-of-Life Care: Essential for guiding care preferences during end-of-life stages.
- 3. Patient Unconsciousness: Helps in decision-making when patients are unable to communicate.
Frequently Asked Question
How do I fill out the POLST form?
You fill out the POLST form during a discussion with your healthcare provider who assists you in specifying your treatment wishes.
Can I change my POLST form?
Yes, a patient can modify or revoke their POLST at any time.
Is the POLST form valid out of state?
The California POLST form is valid in California, but having both this and your advance directive when traveling is recommended.
Who should sign the POLST form?
The POLST must be signed by both the patient and their physician.
What if I cannot communicate my wishes?
A healthcare professional can complete the POLST based on family knowledge of the patient's desires.
What should I do with the completed POLST form?
Keep the original POLST form with you at all times and place it in a visible spot at home.
Can I obtain copies of the POLST form?
Yes, healthcare providers can download the California POLST form from the official website.
What happens if I have both a POLST and an Advance Directive?
If there are conflicts, the most recent document will be followed.
What is included in the POLST form?
The form includes decisions regarding CPR, antibiotics, and other life-sustaining treatments.
How can health care providers use the POLST form?
The POLST helps healthcare providers honor patient wishes and avoid unwanted treatments.
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This file outlines the signature requirements necessary for a valid POLST form across various states. It provides critical insights for healthcare professionals and patients regarding who can sign these forms. Essential for informed healthcare decision-making and related to POLST regulations.
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