Within this page: National Form | Information for Professionals | Patient Guides | Learn more
The National POLST Form was created because having a single form will make it easier to:
- Honor patient treatment wishes throughout the United States
- Conduct research and quality assurance activities to improve the POLST form
- Educate about POLST so it is properly used everywhere
Information for Professionals
National POLST Form
Check with your state or DC program to ensure this form is valid where you are
How to Order the National POLST Form
We are not yet taking orders. Ordering the form is not possible, as it is not yet adopted for use in any state or DC POLST Programs. This will be updated as local programs adopt the form.
Foreign Language Versions
We are planning to offer foreign language translations of the National POLST form; however, these are not yet available.
National POLST Patient Guides
Download our guides below. Patient Guide 1 helps prepare your for talking with your health care provider about POLST. Patient Guide 2 helps explain what your completed POLST form means.
Patient Guide 1
Getting Ready to Talk About POLST
Patient Guide 2
What Your Completed POLST Form Means
Chart: POLST vs. Advance Directives
Explains how these two advance care planning tools differ
Learn more
Please remember that POLST is meant to be centered about conversations between you and your health care provider.
- Explore this website to learn more. You might start with our About POLST page.
- Learn about the POLST Program in your area. View our POLST Map to find your local contacts.
- View our Patient Frequently Asked Questions (FAQs) page.
The National POLST form represents a major step towards national consensus on a POLST form — and many consecutive months of interviews and listening, consensus building, feedback, compromise, and iterative revisions. The National POLST form is new as of August 2019. Learn more by reading the Form Guide above.