Introduction to the Chinese Translation of California POLST Form

POLST is a physician order that gives patients more control over their care during serious illness. Produced on a distinctive bright pink form and signed by both the physician and patient, POLST specifies the types of medical treatment that a patient wishes to receive towards the end of life.

This is a Chinese translation of the California POLST form. The translated form is for educational purposes only to be used when discussing a patient’s wishes documented on the POLST form. The signed POLST form must be in English so that emergency personnel can read and follow the orders.

For questions in English, email
info@coalitionccc.org or call (916) 489-2222. To learn more about POLST, visit www.caPOLST.org.

For questions in Chinese, contact the Chinese American Coalition for Compassionate Care,
admin@caccc-usa.org or call (866) 661-5687.

加州「維持生命治療醫囑」中文表格簡介


‭ ‬在經歷嚴重疾病時,「維持生命治療醫囑」是一份醫生處方,它讓病人在自己的醫療決定上能有更多的自主權。這是一份醫生和病人共同簽署的粉紅色表格,明確告知病人希望接受的生命末期醫療方式。
‭ ‬
這份加州「維持生命治療醫囑」中文表格,僅用於方便華人瞭解英文所述內容以及討論表格上的各項醫療意願。表格必須以英文填寫方具法律效力,而且急救人員也才能看得懂表格來執行醫囑。

如有任何疑問請與下列機構聯絡‭:‬‭ ‬

英文‭:‬請電郵‭ ‬info@coalitionccc.org或致電‭ (‬916‭) ‬489-2222,欲瞭解更多相關資訊,請上網www.caPOLST.org‭ ‬查詢。
‭ ‬
中文‭: ‬美華慈心關懷聯盟‭ ‬admin@caccc-usa.org或致電‭ (‬866‭) ‬661-5687‭ ‬欲瞭解更多相關資訊,請上網www.caccc-usa.org查詢。

Click to Download Traditional Chinese POLST Form

加州「维持生命治疗医嘱」中文表格简介

在经历严重疾病时,「维持生命治疗医嘱」是一份医生处方,它让病人在自己的医疗决定上能有更多的自主权。这是一份医生和病人共同签署的粉红色表格,明确告知病人希望接受的生命末期医疗方式。
这份加州「维持生命治疗医嘱」中文表格,仅用于方便华人了解英文所述内容以及讨论表格上的各项医疗意愿。表格必须以英文填写方具法律效力,而且急救人员也才能看得懂表格来执行医嘱。
如有任何疑问请与下列机构联络:
英文:请电邮info@coalitionccc.org或致电 (916) 489-2222,欲了解更多相关信息,请上网www.caPOLST.org 查询。
中文: 美华慈心关怀联盟admin@caccc-usa.org或致电 (866) 661-5687 欲了解更多相关信息,请上网www.caccc-usa.org查询。

Click to Download Simplified Chinese POLST Form

California Advance Healthcare Directive - Easy Form

An advance healthcare directive allows you to state what kind of healthcare you want if you ever become very sick and are unable to speak for yourself. This way, those who care for you will not have to guess what you want if you are too sick to tell them yourself. This easy-to-read, easy-to-understand form was created for people with limited reading skills and skilled readers alike who read Chinese or Chinese and English.

自己做醫療決定。本指示書讓您選擇自己想要的各項醫護服務
如此一來若您病得太重而無法表達意見時
醫護人員及親友們就不用去猜測您的心意

Click to Download ADVANCE HEALTH CARE DIRECTIVE - Easy Form

Below is the link for the Standard Form of the Advance Health Care Directive. The Standard Form does not contain illustrations.

Click to Download ADVANCE HEALTH CARE DIRECTIVE - Standard Form
Email 郵箱
admin@caccc-usa.org

Toll Free Number 免費電話
(866) 661-5687
Leave a message and someone will contact you.
請留下語音,我們會跟您連絡
Address 地址
P.O. Box 276,
Cupertino, CA 95015

9440 Telstar Ave., #6
El Monte, CA 91731