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Reviewing a POLST Form This POLST form should be reviewed periodically and in light of the patient’s ongoing needs and desires. These include: • transfers from one care setting or care level to another; • changes in the patient’s health status or use of implantable devices (e.g., ICDs/cerebral stimulators);
The IDPH Uniform POLST form is intended to be followed by first responders no matter where a medical crisis might occur, including but not limited to person’s home, hospitals, nursing homes, hospice, and by emergency medical services regardless of location.
Licensed hospitals, certain licensed long-term care facilities, such as nursing homes, and licensed emergency medical services personnel must honor the IDPH Uniform POLST Form, National POLST Form, or authorized out-of-state form, or a copy of that document.
LIFE-SUSTAINING TREATMENT (POLST) FORM State of Illinois Illinois Department of Public Health For patients, use of this form is completely voluntary. Follow these orders until changed. These medical orders are based on the patient’s medical condition and preferences. Any section not completed does not invalidate the form and
Download the 2022 Revised IDPH POLST Form FAQ for Healthcare Professionals EDUCATION ABOUT CHANGES TO THE POLST PROGRAM NOW AVAILABLE! You may be aware that legislation impacting the POLST form and guidance for using POLST in our state went into effect on 1/1/22.
The IDPH POLST form is a signed medical order that documents the life-sustaining treatment wishes of seriously ill patients. The form accompanies the patient to ensure that treatment preferences are honored across all care settings.
In Illinois*, the POLST form is a revised version of the IDPH Uniform DNR Advance Directive. POLST forms are completed after patients discuss their preferences with health care professionals who can explain to them what may happen if different treatments are tried.
Illinois law allows you to make four types of advance directives: a health care power of attorney; a living will; a mental health treatment preference declaration, and a Do-Not-Resuscitate (DNR)/Practitioner Orders For Life-Sustaining Treatment (POLST). Please see the link below for more information about advance directives.
Illinois law allows you to make four types of advance directives: a health care power of attorney; a living will; a mental health treatment preference declaration, and a Practitioner Orders For Life-Sustaining Treatment (POLST).
View, download and print fillable Ioci 17-564 - Idph Uniform Practitioner Order For Life-sustaining Treatment (polst) in PDF format online. Browse 31 Illinois Department Of Public Health Forms And Templates collected for any of your needs.