Additional Notes for Healthcare Professionals


Section A & B

While it is possible to order DNR in Section A but Full Treatment in Section B; in this circumstance, a patient would want all measures provided but would not want to be resuscitated if those attempts fail and their heart stops.  It is not possible to order CPR in Section A and Comfort Measures Only in Section B because, in providing CPR, the next step is for intubation and ventilation, which is not consistent with the Comfort Measures Only option.

  • Comfort measures are always provided, regardless of what treatment option picked.
  • Patients (or surrogates) are not required to sign POLST forms in Oregon but we encourage it.
  •  Validity of POLST form means:
    •  The patient’s full name
    • Patient’s Date of birth
    • A legible physician/NP/PA signature
    • A legible date signed
    • Section A must be completed for the form to be entered into the Registry*

Voiding a POLST Form

A patient with capacity, or his/her valid surrogate when the patient lacks capacity, can void the form and request alternative treatment at any time.  A form is generally voided when “VOID” is written in large letters across the form, but the process varies by state, particularly if there is a state registry to be notified.

Revising a POLST Form

The health care professional responsible for the patient’s care should review and update the POLST form, with the patient or his/her surrogate, as needed based on the patient’s medical condition and treatment preferences.  At a minimum, the POLST should be reviewed in the following circumstances:

(a)    When the patient is transferred from one care setting or care level to another;

(b)   When there is a substantial change in the patient’s health status; and

(c)    When the patient’s primary care professional changes.

A patient with capacity, or his/her valid surrogate  when the patient lacks capacity, may also initiate a revision of a POLST form at any time.

Revisions of POLST forms generally require voiding the current POLST form and writing/signing a new form, as well as giving the patient the updated form with instructions to destroy all older versions and putting the most current form in the patient’s medical record (and archiving the old POLST form).