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September 2, 2010
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Physician Orders for Life-Sustaining Treatment Kit (POLST)

Physician Orders for Life-Sustaining Treatment Kit (POLST)

Physician Orders for Life Sustaining Treatment (POLST) is a legally recognized document, similar to the widely used “Do Not Resuscitate” (DNR) orders. The POLST form, used for patients with a serious illness or whose life expectancy is a year or less, outlines a plan of care reflecting the patient’s wishes concerning medical treatment and interventions at life’s end. The POLST form compliments an advance directive by turning a patient’s treatment preferences into actionable medical orders.

POLST encourages communication between physicians, patients and other members of the health care team, facilitates informed decision making and promotes accurate communication of patient wishes and physician orders across treatment settings and among health care providers.

Preview the POLST Kit here PLEASE NOTE THAT THIS KIT IS COPYRIGHTED.YOU SHOULD NOT REPRODUCE THE SAMPLE KIT IN ANY FORM WITHOUT FIRST OBTAINING THE PERMISSION OF THE CMA.

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1
$6.00
$5.00
2
$9.00
$7.50
3
$12.00
$10.00
4
$15.00
$12.50
5
$18.00
$15.00
10
$30.00
$21.25
25
$60.00
$42.50
50
$114.00
$80.75
100
$216.00
$153.00
200
$420.00
$297.50
500
$900.00
$675.00
1000
$1,560.00
$1,170.00
1500
$2,340.00
$1,750.00
2000
$3,120.00
$2,340.00
2500
$3,750.00
$2,800.00
3000
$4,500.00
$3,360.00
3500
$5,250.00
$3,920.00
4000
$5,520.00
$4,080.00
4500
$6,210.00
$4,590.00
5000
$6,780.00
$5,000.00

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