Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form - Illinois

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.

Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form - Illinois

Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form is a legal document that was released by the Illinois Department of Public Health - a government authority operating within Illinois.

FAQ

Q: What is the IDPH Uniform Practitioner Order for Life-Sustaining Treatment (POLST) form?
A: The IDPH Uniform Practitioner Order for Life-Sustaining Treatment (POLSt) form is a legal document that allows individuals to outline their preferences for life-sustaining treatments in case they become seriously ill or injured.

Q: Is the POLST form specific to Illinois?
A: Yes, the POLST form is specific to Illinois.

Q: Who can complete the POLST form?
A: The POLST form can be completed by a qualified healthcare professional in consultation with the individual, or their legal representative.

Q: What information is included in the POLST form?
A: The POLST form includes information about the individual's preferences regarding CPR, medical interventions, and artificially administered nutrition and hydration.

Q: Is the POLST form legally binding?
A: Yes, the POLST form is a legally binding document that must be followed by healthcare professionals.

Q: Can the POLST form be changed or revoked?
A: Yes, the POLST form can be changed or revoked at any time by the individual or their legal representative.

Q: Who should I contact if I have questions about the POLST form?
A: If you have questions about the POLST form, you should contact a healthcare professional or your local healthcare provider.

ADVERTISEMENT

Form Details:

  • Released on January 1, 2017;
  • The latest edition currently provided by the Illinois Department of Public Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Illinois Department of Public Health.

Download Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form - Illinois

4.6 of 5 (18 votes)
  • Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form - Illinois

    1

  • Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form - Illinois, Page 2

    2

  • Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form - Illinois, Page 1
  • Idph Uniform Practitioner Order for Life-Sustaining Treatment (Polst) Form - Illinois, Page 2
Prev 1 2 Next
ADVERTISEMENT