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
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.
Please remember that POLST is meant to be centered about conversations between you and your health care provider.
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.