This version of the form is not currently in use and is provided for reference only. Download this version of Form DOH-5003 for the current year.

Form DOH-5003 Medical Orders for Life-Sustaining Treatment (Molst) - New York

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What Is Form DOH-5003?

This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DOH-5003?
A: DOH-5003 is the Medical Orders for Life-Sustaining Treatment (MOLST) form used in New York.

Q: What is the purpose of DOH-5003?
A: The purpose of DOH-5003 is to provide medical orders that guide the use of life-sustaining treatments for patients with serious illnesses or conditions.

Q: Who uses DOH-5003?
A: DOH-5003 is used by healthcare professionals and patients in New York.

Q: What information is included in DOH-5003?
A: DOH-5003 includes information about the patient's preferences for life-sustaining treatments, as well as instructions for healthcare providers.

Q: How is DOH-5003 filled out?
A: DOH-5003 is typically filled out by a healthcare professional in consultation with the patient or their surrogate decision-maker.

Q: Is DOH-5003 legally binding?
A: Yes, DOH-5003 is a legally binding medical order in New York, and healthcare providers are required to follow the instructions provided.

Q: Can I change or revoke DOH-5003?
A: Yes, you can change or revoke DOH-5003 at any time by completing a new form or discussing your preferences with your healthcare provider.

Form Details:

Released on August 1, 2020;
The latest edition provided by the New York State Department of Health;
Easy to use and ready to print;
Quick to customize;
Compatible with most PDF-viewing applications;
Fill out the form in our online filing application.

Download a printable version of Form DOH-5003 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.