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What Is a POLST Form (and How Is It Different)?
By Jason Su ·
A POLST is a medical order signed by a clinician — not a document you fill in alone, and not a replacement for an advance directive. It is meant for someone with a serious illness or advanced frailty, and it is designed to travel with them: it tells emergency responders what to do or not do, right now. An advance directive says who decides and what you want. A POLST is a clinician’s instruction that acts on it.
Most people who read this page do not need one yet. That is worth saying plainly, because the most common POLST mistake is filling one out when an advance directive was the right answer.
The one-line difference
| Advance directive | POLST | |
|---|---|---|
| What it is | Your statement of wishes, and who may speak for you | A medical order |
| Who signs it | You, with witnesses or a notary as your state requires | You or your agent, plus a clinician |
| Who it is for | Nearly every adult | People with a serious illness or advanced frailty |
| What it does | Names a decision-maker and records your wishes | Tells responders which treatments to give or withhold |
| Who acts on it | Hospitals, physicians, your agent | Emergency responders, who may act on it immediately |
| How long it lasts | Until you change it | Reviewed as your condition changes; often revisited |
The practical difference is the last two rows. An advance directive requires someone to read it and decide. A POLST is already a decision.
Why the distinction matters in real life
Imagine a paramedic called to your home. They have minutes.
An advance directive is legally important and often not something they can act on directly. A POLST — if it is visible, current, and signed — tells them what to do without a phone call, a hospital, or a family member.
That is the entire value of the document. It exists to be actionable in the field, which is also why it has to be findable.
Who a POLST is for
The general intent, which most state programs share:
- Serious illness where the trajectory is understood — advanced cancer, heart failure, end-stage lung or kidney disease
- Advanced frailty, particularly where several conditions interact
- Anyone for whom CPR or intensive treatment would be unlikely to help, or would impose burdens they would not want
Who it is not for: a healthy person, or someone whose condition is stable. For most readers under 70 with no serious diagnosis, an advance directive is the document to complete, and a POLST would be premature. If in doubt, that is a conversation with a clinician, not a form to download.
What it usually covers
POLST forms vary by state, but the same four decisions appear on almost all of them:
- Whether to attempt CPR if the heart stops
- The level of medical intervention wanted — from comfort-focused care through to full treatment
- Whether to use antibiotics when the purpose is comfort rather than cure
- Whether to use artificially administered nutrition — feeding tubes and similar
Each is a separate choice, and each is made in plain language rather than legal language. That is deliberate: the form is written to be read fast by someone who has never met you.
Who signs it, and why that matters
This is the part that separates a POLST from every other document in this area. A clinician signs it.
A form without a clinician’s signature is not a medical order. It is a piece of paper. If you download a POLST, fill it in, and file it without that conversation, you have not created anything a responder can act on.
The sequence is:
- You or your agent discuss it with a clinician who knows your situation
- The clinician signs
- It is kept where it can be found quickly
Where it has to live
A POLST that cannot be found has no effect. Programs generally recommend that it be:
- Visible, such as on the fridge or by the bed, if that is your situation
- With the person where they move between settings
- Known to the people who come into the home
See what a medical information sheet should include for how the short fridge version and the fuller binder copy fit together.
The name changes from state to state
This is a genuine source of confusion, and it is the same problem as advance directives generally:
| Name | Where you may see it |
|---|---|
| POLST | Most states — Physician Orders for Life-Sustaining Treatment |
| MOLST | Some states — Medical Orders for Life-Sustaining Treatment |
| POST | Some states — Physician Orders for Scope of Treatment |
| MOST | Some states — Medical Orders for Scope of Treatment |
| TPOPP | Some states — Transportable Physician Orders for Patient Preferences |
They are the same idea under different names, and not every state has a program. If your state uses a different term, a search for “POLST” may find nothing official — check what your state calls it.
Neither the name nor the program is uniform, so use the official source rather than a template site. Our state table shows where each state publishes its own forms.
It does not replace an advance directive
These two documents do different jobs, and one does not cover for the other:
- An advance directive is the foundation. It names your agent and records your wishes, and it applies in every healthcare setting.
- A POLST is a specific, actionable order for someone whose situation calls for one. It supplements, and it can change as a condition changes.
Completing a POLST without an advance directive leaves you naming nobody. Completing an advance directive without a POLST is entirely normal and, for most people, entirely sufficient.
What not to do
- Do not download a POLST and fill it in alone. Without a clinician’s signature it is not an order, and it will not be acted on.
- Do not treat it as a substitute for an advance directive. It does not name your agent.
- Do not fill one out “just in case” while healthy. It is intended for a specific clinical situation, and a premature order can misrepresent you later.
- Do not put it somewhere safe and private. Its only value is in being found fast. A POLST in a locked filing cabinet is a POLST that does not exist.
- Do not assume it lasts forever. As a condition changes, the order should be reviewed — a POLST written two years ago may no longer reflect the situation.
- Do not assume “POLST” is what your state calls it. Check the official source for your state.
Frequently asked
Is a POLST the same as a living will?
No. A living will records what you would want in certain end-of-life situations; it is part of an advance directive. A POLST is a signed medical order that a responder can act on immediately.
Do I need a POLST?
If you are asking and you are reasonably healthy, probably not yet. It is generally intended for people with a serious illness or advanced frailty. Check with a clinician who knows your situation rather than deciding from a website — including this one.
Who signs a POLST?
You, or your agent where the state allows, and a clinician — commonly a physician, nurse practitioner, or physician assistant. The clinician’s signature is what makes it an order.
Where should I keep it?
Where someone arriving in an emergency will see it, and where the people caring for you know to look. Many programs suggest a visible location in the home.
Does it work in a hospital, or only at home?
It is intended to be followed across settings, which is why it is designed to travel. Hospitals will also have their own processes, and they will typically ask for it.
What if my state does not have a POLST program?
Then clinicians in your state will use their own processes, and your advance directive and agent carry more of the weight. Check your state’s official sources rather than substituting a form from somewhere else.
Can I change my mind?
Yes. A POLST can be revised or revoked with your clinician, and it should be reviewed as circumstances change. An order that no longer reflects the situation is worse than none.
Next step
If you are reasonably healthy, the document you want is an advance directive, not a POLST. Find your state’s official source and complete that first — it names your agent and works everywhere.
If you or someone you are caring for has a serious illness, ask a clinician whether a POLST is appropriate, and get the form from your state’s program rather than from a website. Then confirm where it should be kept — and record that using the free Checklist Builder so the people who need it know where it is.
This is general information, not medical or legal advice. We are not a law firm and we do not give medical advice. POLST programs, names, requirements, and who may sign differ by state and change over time — please confirm details with your clinicians and your state’s official source.
General information only. Rules vary by state and change over time. Confirm details with the official source before acting. Read the full disclaimer.