Ordering Oregon POLST® Forms and Materials
The New 2023 Version of the Oregon POLST Form is Available Now!
It is always the best practice to use the most up-to-date POLST form.
Pre-existing POLST forms remain valid as long as the patient’s wishes have not changed. A new POLST using the revised 2023 form does not need to be completed to duplicate existing orders.
Please remember a POLST is:
- Always voluntary and cannot be required
- A medical order for people with a serious illness or frailty
- An expression of wishes for emergency treatment in one’s current state of health (if something happened today)
Please note: Only health care professionals and medical organizations may order POLST forms. We distribute to health care professional organizations with the goal of assuring that POLST is used in the appropriate patient population. Such medical professionals are considered as personnel of medical institutions with an authorized signer of: MD, DO, NP, PA or ND, including hospitals, clinics, hospices, memory care units and SNFs.
Independent living communities, assisted living facilities and adult foster care homes do not qualify to order POLST forms, but should refer residents to their primary care professionals for a POLST conversation.
*Sample POLST forms for patient education may be ordered by non-medical professionals or may be downloaded to self-print at no-cost by clicking HERE.
If you are a patient who wants a POLST, you should schedule an appointment with your medical professional/doctor to discuss:
- Your current health conditions, and
- If these medical orders are appropriate for you.
The POLST is not a substitute for the Advance Directive. Learn more about the Oregon Advance Directive here.
2023 Oregon POLST® Form
The 2023 Oregon POLST form (version 14) is now in use and is being accepted as the current version. The Oregon POLST Coalition requests all Oregon health systems to implement the use of the 2023 form when creating new orders.
Entities interested in printing their own forms should contact the Oregon POLST Program at firstname.lastname@example.org.
2011, 2014, 2018 and 2019 versions of the Oregon POLST form are currently being accepted for submission by the Oregon POLST Registry.
Need a POLST form in another language?
Note: A signed POLST must be in English, so emergency personnel can read and follow the orders.
However, the front page of the Oregon POLST form has been translated into 14 other languages for educational purposes only. The full list of these translated “sample” versions can be found under Educational Tools on our Resources page.
Visit our Español page to find more Spanish POLST resources, including videos and patient stories.
Request POLST Forms or Educational Materials
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