Cardiopulmonary Resuscitation Info Services Forms for Riverside

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FAQ

A health care professional, usually a doctor, nurse, or social worker, completes the form after having a conversation with the patient to understand his/her wishes and goals of care. Both a doctor and the patient must sign the POLST form in order for it to be valid.

The primary difference between and POLST and DNR is that a POLST covers a variety of end-of-life treatments. A DNR only gives instructions about CPR. With a POLST, seniors can specify: If they do or don't want CPR.

An advance directive is a direction from the patient, not a medical order. In contrast, a POLST form consists of a set of medical orders that applies to a limited population of patients and addresses a limited number of critical medical decisions.

If you prefer to order by mail, you can download a DNR bracelet order form by clicking on California DNR / POLST Bracelet Mail Order Form. Or, you can place your order online by clicking on either the bracelet or pendant photo below.

The Physician Orders for Life Sustaining Treatment (POLST) form is a written medical order from a physician, nurse practitioner or physician assistant that helps give people with serious illnesses more control over their own care by specifying the types of medical treatment they want to receive during serious illness.

POLST Physician Orders for Life-Sustaining Treatment Physician Orders for Life-Sustaining Treatment (POLST) is a form that gives seriously-ill patients more control over their end-of-life care, including medical treatment, extraordinary measures (such as a ventilator or feeding tube) and CPR.