Montana Board of Medical Examiners


  • POLST is the Providers Orders for Life-Sustaining Treatment (POLST) program in Montana.  It is designed to improve the quality of care people receive at the end of life.  This is accomplished by the development of an effective communication process to assure patient wishes are communicated to the medical providers.  The process utilizes a POLST form, which is official documentation of medical orders on a standardized form coupled with a promise by health care professionals to honor those wishes.
  • The Provider Orders for Life-Sustaining Treatment (POLST) form represents a way of summarizing wishes of an individual regarding life-sustaining treatment. The form is intended for any individual with an advanced life-limiting illness. The form accomplishes two major purposes: it is portable from one care setting to another and it translates wishes of an individual into actual medical orders. The attending physician, nurse practitioner (APRN) or physician assistant (PA) should complete the document with the patient. The attending physician, APRN or PA must sign the form and assume full responsibility for its accuracy. The POLST form facilitates the process of translating end-of-life discussions with patients into actual treatment decisions, and provides security for the individual and physician that the expressed wishes will be carried out. There is no other form that streamlines the process in this way.
  • In a health care facility, the form should be the first document in the clinical record. It should be recognized as a set of medical orders, to be implemented as any medical orders would. In a non-institutionalized setting (such as a home), the form should be located in a prominent location. It will be recognized by emergency personnel as orders to be followed.
  • The form must be transferred with the individual to be valid. The institution may wish to keep a duplicate copy in the permanent medical record upon discharge.
  • Yes. A provider (physician, nurse practitioner, or physician assistant) must sign the form in order for it to be a medical order that is understood and followed by other health care professionals.
  • If you have a signed POLST form, The Department of Public Health & Human Services and Board of Medical Examiners recommends you also have an advanced directive, though it is not required. You may obtain more information about advanced directives from your provider.
  • If you are the designated health care representative, you can speak on behalf of your loved one. A provider can complete the POLST form based on your understanding of your loved one’s wishes.
  • The completed POLST form is a provider order form that will remain with you if you are transported by an ambulance, transported between care settings, regardless of whether you are in the hospital, at home or in a long-term care facility.
  • If you live at home you should keep the original POLST form in a prominent location (e.g., on the front of the refrigerator, on the back of the bedroom door, on a bedside table, or in your medicine cabinet). If you reside in a long-term facility, your POLST form may be kept in your medical chart along with other medical orders.
  • No, Comfort One is still honored by EMT personnel and your wishes will still be followed by the EMT personnel.  You may wish to discuss POLST with your provider if you want your wishes expanded beyond withholding life sustaining treatment at home or wish the medical facilities and other medical providers to honor your wishes.
  • From your physician or other health care provider or you can download a copy from the website,
    If your physician or other health care provider is not yet aware of, or needs more information about POLST you can direct them to the official POLST website for Montana at:
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