South Carolina POST Form 4061: Scope of Treatment

South Carolina's portable medical order, under the POST Act in Title 44 Chapter 80, records CPR, medical intervention, antibiotic and artificial nutrition and fluid decisions. It is limited to patients diagnosed with a serious illness or expected to lose capacity within 12 months. Clinicians complete it with the patient or legal representative, and it is valid across health care settings once signed by both.

Who completes it

A physician, APRN or PA completes Sections A to D and signs Section E, attesting that the patient has a serious illness or may be expected to lose capacity within 12 months and that the orders fit. The patient or legal representative signs Section F, and any facilitator signs Section G.

Submitting and payment

How to submit it
Nothing is filed with the state; the form must accompany the patient when transferred or discharged, and copies, faxes and electronic versions are legal.

Good to know

  • The physician responsible for the form should make reasonable efforts to review and update it with the patient as needs dictate, and at least once a year.
  • An APRN may sign only if authorized by the practice agreement, and a PA only if authorized by scope of practice guidelines, for their own or the supervising physician's patients.
  • The patient or legal representative can revoke it orally or in writing, effective once communicated; a new POST automatically revokes earlier ones.
  • The current form is 4061-ENG-DPH (07/2024) from the Department of Public Health, formerly issued by DHEC as D-4061.

Get the official form

Download the current version from the source each time; forms change without notice.

South Carolina Physician Orders for Scope of Treatment (POST)

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

When does a South Carolina POST form take effect?

On the date it has been completed, executed and signed by the physician, APRN or PA and by the patient or legal representative. It remains effective until revoked or replaced by a new POST, and a properly executed form from another state is also treated as valid.

Who counts as a legal representative on the South Carolina POST?

The POST Act defines it as a person with priority to make health care decisions for the patient under the South Carolina Adult Health Care Consent Act, Section 44-66-10 and following. That representative can sign Section F and can revoke the form on the patient's behalf.