{"id":158,"date":"2024-06-23T05:53:11","date_gmt":"2024-06-23T05:53:11","guid":{"rendered":"https:\/\/caccc-usa.org\/?page_id=158"},"modified":"2026-07-08T15:55:56","modified_gmt":"2026-07-08T22:55:56","slug":"polst-forms","status":"publish","type":"page","link":"https:\/\/caccc-usa.org\/en_us\/resources\/polst-forms\/","title":{"rendered":"POLST Forms"},"content":{"rendered":"\n

POLST is a medical order that gives patients more control over their care during serious illness. Signed by the patient and by a physician, nurse practitioner or physician assistant, POLST lists the types of medical treatment that a patient wishes to receive during serious illness.<\/p>\n\n\n\n

\"Chinese<\/figure>\n\n\n\n
<\/div>\n\n\n\n

United States<\/h2>\n\n\n\n
\n

California<\/h3>\n\n\n\n

California’s POLST is called the Physician Orders for Life-Sustaining Treatment (POLST) and is produced on a distinctive bright pink form.<\/p>\n\n\n\n

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\u2019s wishes documented on the POLST form. The signed POLST form must be in English so that emergency personnel can read and follow the orders.<\/strong><\/p>\n\n\n\n

For questions, please contact the following organizations:<\/p>\n\n\n\n

English: Email info@capolst.org<\/a> or call (916) 489-2222. To learn more about POLST, visit www.caPOLST.org<\/a>.<\/p>\n\n\n\n

Chinese: Contact the Chinese American Coalition for Compassionate Care, admin@caccc-usa.org<\/a> or call (866) 661-5687.<\/p>\n\n\n\n

\n
POLST English Form<\/a><\/div>\n\n\n\n
POLST Traditional Chinese Form<\/a><\/div>\n\n\n\n
POLST Simplified Chinese Form<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
\n

Hawaii<\/h3>\n\n\n\n

Information on Hawaii\u2019s POLST can be found at the link below.<\/p>\n\n\n\n

\n
POLST Information<\/a><\/div>\n<\/div>\n\n\n\n
\n
POLST English Form<\/a><\/div>\n\n\n\n
POLST Traditional Chinese Form<\/a><\/div>\n\n\n\n
POLST Simplified Chinese Form<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
\n

New Jersey<\/h3>\n\n\n\n

New Jersey’s POLST is called the Practitioner Orders for Life-Sustaining Treatment (POLST).<\/p>\n\n\n\n

\n
POLST Form<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
\n

New York<\/h3>\n\n\n\n

New York’s POLST is called the Medical Orders for Life-Sustaining Treatment (MOLST).<\/p>\n\n\n\n

\n
MOLST Form<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
\n

Virginia<\/h3>\n\n\n\n

Virginia’s POLST is called the Physician Orders for Scope of Treatment (POST).<\/p>\n\n\n\n

\n
POST Form<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
\n

Texas<\/h3>\n\n\n\n

Texas’ POLST was also previously called the Medical Orders for Scope of Treatment (MOST).<\/p>\n\n\n\n

\n
POLST Form and Other Resources<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
\n

Other States<\/h3>\n\n\n\n

Search for POLST forms by state at the link below.<\/p>\n\n\n\n

\n
POLST Forms by State<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
<\/div>\n\n\n\n

Taiwan<\/h2>\n\n\n\n
\n

Taiwan<\/h3>\n\n\n\n

In Taiwan, POLST is part of the \u9810\u7acb\u91ab\u7642\u6c7a\u5b9a\u66f8.<\/p>\n\n\n\n

\n
\u9810\u7acb\u91ab\u7642\u6c7a\u5b9a\u66f8<\/a><\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

POLST is a medical order that gives patients more control over their care during serious illness. Signed by the patient and by a physician, nurse practitioner or physician assistant, POLST lists the types of medical treatment that a patient wishes to receive during serious illness. 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