Physician Orders for Life-Sustaining Treatment Form
The California Coalition for Compassionate Care is a statewide partnership of more than 60 regional and statewide organizations dedicated to the advancement of palliative medicine and end-of-life care in California. Its mission is to promote high-quality, compassionate end-of-life care for all Californians.
POLST for Healthcare Professionals
POLST — Physician Orders for Life-Sustaining Treatment — is a physician’s order that outlines a plan of care reflecting the patient’s wishes concerning care at life’s end. The POLST form is voluntary and is intended to help physicians and their patients discuss and develop plans to reflect their wishes, and to assist physicians, nurses, healthcare facilities, and emergency personnel in honoring a person’s wishes for life-sustaining treatment.
California POLST Form Is Now Available!
The California POLST form is now available for use throughout the state. In order to maintain continuity, The Coalition asks that you follow these simple instructions:
*** COPY OR PRINT POLST FORM ON 65# COVER PULSAR PINK PAPER STOCK ***
Wausau Pulsar Pink card stock is available online and at some office supply stores. It is important to use this specific color of paper so that the form can be photocopied and faxed.