Oklahoma Physician Orders for Life-Sustaining Treatment
This file contains important physician orders regarding life-sustaining treatment for patients with advanced illnesses in Oklahoma. It ensures that medical care aligns with the patient's wishes and updates treatment orders based on health changes. Review and complete this form to document and communicate patient preferences effectively.
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How do I fill this out?
Filling out this document is essential to ensure your medical preferences are honored. Begin by reviewing the sections carefully and consult with your healthcare representative if needed. Ensure to sign and date the form to make it valid.

How to fill out the Oklahoma Physician Orders for Life-Sustaining Treatment?
1
Review the POLST form intent and sections.
2
Consult with your healthcare provider or representative.
3
Complete required sections regarding treatment preferences.
4
Sign and date the form appropriately.
5
Store and share the form with healthcare providers.
Who needs the Oklahoma Physician Orders for Life-Sustaining Treatment?
1
Patients with advanced illnesses who want to communicate their treatment preferences.
2
Family members seeking to ensure their loved ones' wishes are respected.
3
Healthcare providers who require clear instructions on patient care.
4
Legal representatives required to make healthcare decisions.
5
Caregivers needing guidance on necessary treatments for their patients.
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Editing this PDF on PrintFriendly is straightforward and user-friendly. Start by opening the PDF in our editor, where you can easily update fields to reflect the latest treatment preferences. After making your changes, download the revised document for future use.
1
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Select the text or fields you want to modify.
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Enter the new information as needed.
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What are the instructions for submitting this form?
To submit this POLST form, please fax it to your local healthcare facility at (123) 456-7890 or email it to treatment@healthcareprovider.com. You can also submit it in person to the medical records department at your local hospital. Make sure to keep a copy for your records, and check with your healthcare provider to ensure they have received it.
What are the important dates for this form in 2024 and 2025?
The POLST form must be reviewed at least annually or earlier if health status changes significantly. Ensure that you are aware of the need for updates particularly during hospital admissions or discharges.

What is the purpose of this form?
The POLST form serves to document a patient's treatment preferences regarding life-sustaining measures. It allows individuals to communicate their wishes clearly with healthcare providers, ensuring alignment with their values. By filling out the form, patients can avoid unwanted procedures and ensure comfort in their remaining time.

Tell me about this form and its components and fields line-by-line.

- 1. Patient Identification: Captures the patient's personal information including name and date of birth.
- 2. Cardiopulmonary Resuscitation (CPR): Specifies whether to attempt resuscitation or not.
- 3. Medical Interventions: Outlines the range of medical interventions the patient wishes to receive.
- 4. Patient Preferences: Allows the patient to express their goals and preferences for care.
- 5. Signature: Requires signatures from the patient or the patient's representative and a physician.
What happens if I fail to submit this form?
Failing to submit the POLST form may lead to medical interventions that do not match the patient’s intentions. Patients could receive life-sustaining treatments that they did not want. This could result in unnecessary suffering or conflict among family members.
- Unwanted Medical Treatment: Patients may receive treatments that contradict their wishes.
- Family Conflicts: Lack of clear directives may lead to disputes among family members about treatment decisions.
- Increased Healthcare Costs: Unwanted interventions can lead to unnecessary expenses and prolonged hospital stays.
How do I know when to use this form?

- 1. Serious Illness: For patients dealing with advanced illnesses needing to document treatment preferences.
- 2. Transition of Care: When patients are being transferred between care facilities.
- 3. Change in Health Status: Following any significant changes in condition that affect medical care.
Frequently Asked Questions
What is the purpose of this POLST form?
The POLST form documents your medical treatment preferences in alignment with your health conditions.
How can I fill out the POLST form?
Begin by reviewing the sections, consulting with a healthcare provider if necessary, and ensuring every relevant part is signed.
Who should use the POLST form?
This form is designed for patients with advanced illnesses, their families, and healthcare providers.
Can I edit the POLST form?
Yes, you can easily edit the form using the PrintFriendly PDF editor before saving.
How do I share the POLST form?
After editing, you can share the document via email or directly through generated links.
What happens if I don't complete the form?
If the form is not submitted, patients may receive treatment that does not reflect their preferences.
Can family members assist in completing the POLST form?
Yes, family members can help complete the form to ensure it accurately reflects patient preferences.
Is the POLST form legally binding?
Yes, once signed by the patient and physician, the POLST form is legally binding in Oklahoma.
When should I review my POLST form?
The form should be reviewed annually or whenever there is a significant change in your health status.
Can I sign the POLST form digitally?
Yes, PrintFriendly offers a feature for adding signatures digitally to your POLST form.
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