POLST Forms
Educational Materials
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Informational Videos
The “Understanding POLST” video provides a clear, detailed overview of the Oregon POLST Program and form using language that individuals without a health care background can understand. The video explains the purpose of POLST and then describes each section of a POLST form. The video is also available for free on the Oregon POLST YouTube channel.
The “Understanding POLST” video in Spanish provides a clear, detailed overview of the Oregon POLST Program and form using language that individuals without a health care background can understand. The video explains the purpose of POLST and then describes each section of a POLST form. The video is also available for free on the Oregon POLST YouTube channel.
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All orders are shipped USPS ground. Please allow 7-10 business days for delivery. The prices above include shipping cost. You will receive an invoice for the cost of the materials with your shipment.
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Ordering Oregon POLST Forms and Materials

The POLST order form is for Health Care Professionals and organizations only. Individuals seeking to obtain a POLST Form may do so through their doctor.

Oregon POLST Form to be revised for 2018

SB 856 (Allows Naturopathic Physicians to sign POLST) goes into effect on January 1, 2018. In response to this statutory requirement, the POLST form will be revised. All prior year form versions will continue to be honored. Like all previous versions, the 2018 POLST form will be a result of changes and updates suggested by POLST stakeholders, quality data from the Oregon POLST Registry, and the addition of effective elements from other state POLST forms. The revised Oregon POLST form and a summary of the changes will be available at the end of November. 

Need a Spanish POLST form?

The POLST form is read by emergency medical personnel, nurses, and physicians who may speak only English.  In order for POLST Forms to be portable, they must be in English.  However, a Spanish form is available to help explain the orders to Spanish speaking persons, but the only form that is valid to be used in the field is in English version.

Click here for an Oregon POLST form to print.