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When you are seriously ill, making sure your loved ones and doctors know what kinds of medical treatment you want as you approach the end of your life is very important. Physician Orders for Life-Sustaining Treatment (POLST) can help do just that.

POLST is a form that clearly states what kinds of medical treatment patients want toward the end of their lives. Printed on bright pink paper, and signed by both a patient and physician, nurse practitioner or physician assistant, POLST helps give seriously-ill patients more control over their care.

POLST also helps you talk with your healthcare team and your loved ones about your choices. In this way, POLST can help reduce patient and family suffering, and make sure that your wishes are known and honored.

Download our POLST guide below in English, Spanish or Chinese.

Have more questions about POLST and what it means? Find out more through our Frequently Asked Questions.



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Download the PDF version of our POLST FAQ’s for Patients and Loved Ones here.

What does ‘POLST’ stand for?

POLST stands for Physician Orders for Life-Sustaining Treatment.

What is the POLST form?

POLST is a physician order that helps give seriously-ill patients more control over their end-of life care. Produced on a distinctive bright pink form and signed by both the doctor and patient, POLST specifies the types of medical treatment that a patient wishes to receive towards the end of life. As a result, POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure that patients’ wishes are honored.

What information is included on the POLST form?

The decisions documented on the POLST form include whether to:

  • Attempt cardiopulmonary resuscitation
  • Administer antibiotics and IV fluids
  • Use a ventilator to help with breathing
  • Provide artificial nutrition by tube

Is POLST required by law?

Filling out a POLST form is entirely voluntary, but California law requires that health care providers follow the physician orders in a POLST form.

Who would benefit from having a POLST form?

POLST is designed for seriously-ill individuals, or those who are in very poor health, regardless of their age.

Does the POLST form replace traditional Advance Directives?

The POLST form complements an Advance Directive and is not intended to replace that document. An Advance Directive is still necessary to appoint a legal health care decisionmaker, and is recommended for all adults, regardless of their health status.

If someone has a POLST form and an Advance Directive that conflict, which takes precedence?

If there is a conflict between the documents, the more recent document would be followed.

Who completes the POLST form?

A health care professional, usually a doctor, nurse, or social worker, completes the form after having a conversation with the patient to understand his/her wishes and goals of care. Both a doctor and the patient must sign the POLST form in order for it to be valid.

What if my loved one can no longer communicate her/his wishes for care?

A health care professional can complete the POLST form based on family members’ understanding of their loved one’s wishes. The appointed decisionmaker can then sign the POLST form on behalf of their loved one.

What happens to my POLST form after it is completed and signed?

The original POLST form, on bright pink paper, stays with you at all times.

  • In a hospital, nursing home, or assisted living facility, the form will be in your medical record or file.
  • If at home, place your form in a visible location so it can be found easily by emergency medical personnel – usually on a table near your bed, or on the refrigerator.

Can I change my POLST form?

Yes, you can change your POLST form at any time should your preferences change. It is a good idea to review the decisions on your POLST form when any of the following occur:

  • You are transferred from one setting to another, for example you go from your home to the hospital, or you are discharged from the hospital to a nursing home
  • There is a change in your overall health, or you are diagnosed with an illness
  • Your treatment preferences change for any reason

What happens if I don’t have a POLST form?

Without a POLST form, emergency medical personnel, nurses and doctors would not know your treatment wishes. You will most likely receive all possible treatments, whether you want them or not. Talking about your treatment choices with your loved ones and doctor before a problem occurs can guide them and help ensure you get the care you want.

Are faxed copies and/or photocopies valid? Must pink paper be used?

Faxed copies and photocopies are valid. Ultra Pink paper is used to distinguish the form from other forms in the patient’s record; however, the form will be honored on any color paper.

How can I get a POLST form?

Patients can request the form from their health care provider. It is important to discuss your goals of treatment with your health care provider so you can decide if POLST is right for you, and how to document your decisions appropriately on the form. The form can also be found at capolst.org, along with other helpful resources.

Is there a POLST wallet card or something small I can carry?

California does not have an official POLST wallet card. Your POLST can be photocopied, folded and carried in your wallet. A photocopy on any paper is valid. You may also order a POLST/DNR medallion which can be worn on a necklace or bracelet to alert emergency providers.

Where can I get a POLST medallion?

The California Emergency Medical Services Authority (EMSA) maintains a list of approved vendors for California POLST/DNR bracelets and other medallions that can be worn to alert emergency providers about the existence of a POLST.  View the current list on the EMSA website at https://emsa.ca.gov/dnr_and_polst_forms/ or call EMSA at (916) 322-4336.

Where do they use POLST now?

POLST was originally developed in Oregon. There are a number of states which currently have POLST programs in place or that are developing POLST programs. For more information on the national POLST effort, visit www.polst.org.

When was POLST authorized in California?

California State POLST Legislation (AB 3000 (Statutes 2008, Chapter 266)) went into effect on January 1, 2009.

What if I travel to another state – will my POLST form be valid?

The California POLST form is valid in California. If you are traveling to another state, it is a good idea to take both your Advance Directive and your POLST form with you. Both documents, even if not legally binding, will help health care providers know your wishes.

I heard that there’s a national POLST form.  Is that form valid in California?

The California POLST form is currently the only legally recognized POLST in California.

How can I find out more about POLST?

Talk to your doctor, or visit the California POLST website at www.capolst.org or the National POLST website at www.POLST.org.