Physician Orders for Life-Sustaining Treatment (POLST) is a form that gives seriously-ill patients more control over their end-of-life care, including medical treatment, extraordinary measures (such as a ventilator or feeding tube) and CPR. Printed on bright pink paper, and signed by both a patient and physician, nurse practitioner or physician assistant, POLST can prevent unwanted or ineffective treatments, reduce patient and family suffering, and ensure that a patient's wishes are honored.
Download the POLST form.

When you purchase your POLST forms through Med-Pass, you are supporting
the Coalition for Compassionate Care of California. Thank you!

The Coalition for Compassionate Care of California has created and compiled a variety of resources to help educate patients, caregivers, and healthcare professionals on the issues – both medical and deeply personal – surrounding POLST.