To submit the POLST form, you can follow these steps: 1. Review the completed form with your healthcare provider to ensure it accurately reflects your medical preferences. 2. Sign the form along with your healthcare provider. 3. Submit a copy to your healthcare provider's office and ensure they include it in your medical records. 4. Keep a copy for yourself and distribute copies to key family members and caregivers. 5. Consider submitting a copy to local emergency medical services or your hospital of choice. My advice is to always keep the form accessible and up-to-date. Regularly review your preferences and update the form as necessary.

There are no specific dates for the POLST form itself, as it is used on an as-needed basis whenever medical treatment preferences need to be documented. Review and update annually or after significant changes in your health.

The purpose of the POLST form is to ensure that patients' medical treatment preferences are clearly communicated and respected during emergencies when they cannot speak for themselves. The form facilitates important discussions between patients, their families, and healthcare providers about end-of-life care and other significant medical decisions. By completing the POLST form, patients can have peace of mind knowing their treatment wishes will be followed.

• 1. Patient Information: Details about the patient including name, date of birth, and contact information.
• 2. Cardiopulmonary Resuscitation Orders: Choices regarding CPR, whether to attempt resuscitation or not if the patient has no pulse and is not breathing.
• 3. Goals of Care and Medical Treatments: Selection of treatment goals such as full treatment, selective treatment, or comfort-focused treatment.
• 4. Medically Assisted Nutrition: Preferences regarding the use of tube feeding and other forms of assisted nutrition.
• 5. Additional Orders: Any other specific medical orders not covered in the previous sections.
• 6. Signatures: Signatures of the patient (or representative) and the healthcare provider to validate the form.

If you fail to submit the POLST form, standard care procedures will be followed in a medical emergency.

• Unwanted Medical Interventions: Without the POLST form, you might receive treatments that you do not desire.
• Lack of Clarity: Healthcare providers may not be aware of your treatment preferences, leading to confusion.
• Stress for Family Members: Family members may face stress and uncertainty in making medical decisions on your behalf without clear guidance.

• 1. Serious Illness: If you have a serious illness that could lead to medical emergencies.
• 2. Advanced Age: For elderly individuals who want to ensure their end-of-life care preferences are known.
• 3. After Hospitalization: Following a significant hospital stay, to update your treatment preferences.
• 4. Change in Health: If your health condition changes significantly, necessitating an update to your medical orders.
• 5. Annual Review: Reviewing and updating the POLST form annually to ensure it reflects your current wishes.