Physician Orders for Life-Sustaining Treatment (POLST)


The POLST (Physician Orders for Life-Sustaining Treatment) form is intended for any individual with serious health conditions.

The POLST form asks for information about:

  • Your preferences for resuscitation
  • Medical conditions
  • The use of antibiotics
  • The use of artificially administered fluids and nutrition

The POLST form will translate your wishes as expressed in your health care directive into clear and specific medical orders. 

This will assist physicians, nurses, health care facilities and emergency personnel in providing appropriate treatment.

A POLST form can be obtained at your physician's office. It must be signed by both you and your physician before it is valid.


For More Information

If you have questions, you can contact the Advance Care Planning team at 425.899.6306 or by email.