Physician Orders for Life Sustaining Treatment (POLST)
POLSTs give patients with a serious illness increased control in how their end-of-life wishes are honored. In California, POLST forms are bright pink and need to be signed by both you and your doctor to be valid. They are intended to complement advance directives rather than replace them.
Guide decisions of emergency medical services outside of the hospital setting.
Provide specific information about the use of ventilators and attempts at cardiopulmonary resuscitation.
Should be completed only for those experiencing serious illness and have specific requests about end-of-life care.
Need to be kept in a location visible to medical first responders (paramedics).
Must be completed in English; however, the form is available in different languages for reference.
The Polst Guide (PDF) is provided by the California Coalition for Compassionate Care to address frequently asked questions about POLST. The California POLST website has more information and resources about Physician Orders for Life Sustaining Treatment.
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HOW TO REFER
Fax a referral form with supporting documentation to 650-320-9443.
Please note, though this form is from Stanford Health Care, it is also used for all Cancer Center referrals.
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