[download PDF]

[download PDF]

Sample POLST policies from hospitals and nursing homes.
Sample hospital Policy 1
Sample hospital Policy 2
Sample Nursing Home Policy 1
Sample Nursing Home Policy 2
Sample POLST Flow Chart

Link to the Department of Health POLST Resources. [click here]

[click here]

Legal Requirements and General Guidance for Addressing End of Life Care in the Context of Advance Directives, Surrogate Decision-Making and Organ Procurement. [click here]

[English (PDF) | Spanish (PDF)]

A sample powerpoint presentation for your use in POLST presentations. This presentation is based on the old POLST form.
[download]

A list of individual contacts for more information on POLST. [download]

A link to the Oregon POLST website.
[click here]

A brochure for your use in your facility.  You can download the document and customize to your facility or order copies in English or Spanish.

Download Brochure (Adobe Acrobat): English | Spanish
Download Brochure (Adobe Pagemaker): English | Spanish

This downloadable form is meant to serve as a master copy to be used to print bulk quantities (or single copies) of the form. It should be printed on 8-1/2" x 11" green card stock, front and back. For the card stock, you can use Astrobrights terra green (smooth finish), 65 lbs. (#22781), or an equivalent.
[download POLST form (PDF)]

The Physician Orders for Life Sustaining Treatment, or POLST, form can also be downloaded from the WSMA's Web site.
[click here] [training video]