A POLST (Practitioner Orders for Life-Sustaining Treatment) should be strongly considered for any patient for whom death in the next 12 months would not be surprising. This includes patients with metastatic or end-stage organ disease, those having a terminal diagnosis, those receiving hospice or palliative care, and those who currently have or have had in the past DNR status. POLST may also be appropriate for patients permanently residing in long-term care facilities.
A valid POLST form must be completed in English.
New Jersey POLST Forms (PDF):
Share With Your Patients
The NJ POLST Form Video Series introduces patients and families to this document and explains how to complete this form with a healthcare provider.