Folder The Pennsylvania Orders for Life-Sustaining Treatment (POLST) Form

The POLST FORM and brief information on its development and use in Pennsylvania is accessible at the following links.

Users are asked to print copies of the form on pulsar pink card stock (65#). The POLST Wallet Card should be printed on both sides of page.

Documents

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pdf Critical POLST Facts ( pdf, 84 KB ) (6509 downloads) Popular
pdf Introduction to the POLST Form ( pdf, 189 KB ) (12303 downloads) Popular
pdf POLST and the Out of Hospital Do Not Resuscitate Order, Similarities and Differences ( pdf, 38 KB ) (12065 downloads) Popular
pdf POLST form, English version ( pdf, 223 KB ) (49717 downloads) Popular
pdf POLST form, Spanish version ( pdf, 153 KB ) (3840 downloads) Popular
pdf POLST Wallet Card ( pdf, 158 KB ) (7517 downloads) Popular