Connecticut MOLST: Life-Sustaining Treatment Orders

Connecticut patients with an end-stage serious life-limiting illness or advanced chronic progressive frailty can have their goals of care and treatment choices written as MOLST medical orders. The provider records the goal of care, then choices on CPR, intubation and CPAP or BiPAP, hydration and nutrition, dialysis, antibiotics, blood products and vasopressors. Every health care provider must follow a valid MOLST.

Who completes it

A physician, APRN or PA who has completed the DPH-mandated MOLST training completes the orders and signs, and the patient or legally authorized representative also signs. The provider signature attests to the training and compliance with CGS 19a-580h.

Submitting and payment

How to submit it
Nothing is filed with DPH; the orders take effect on signature, the patient may keep the paper form, and photocopies, faxes and electronic copies are valid.

Good to know

  • Provider certification comes from an online self-study course of about 30 to 45 minutes, and only certified MOLST providers may sign.
  • DPH publishes a fillable digital version with e-signature fields, last updated May 2026, alongside a non-fillable version of the form.
  • Any substantive change requires voiding the form, writing VOID across both pages of a paper copy, and completing a new MOLST.
  • MOLST is not intended for people with significant disabilities who choose to live with life-supporting interventions such as medical feeding or ventilators.

Get the official form

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

Connecticut Medical Orders for Life-Sustaining Treatment (MOLST)

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

Who can sign a Connecticut MOLST?

Only a physician (MD or DO), APRN or PA-C who has completed the MOLST training required under Conn. Gen. Stat. 19a-580h. The training is an online self-study program, and a certificate is issued on completion. The patient or legally authorized representative must also sign.

Is a DNR bracelet still valid with a Connecticut MOLST?

Yes. The form states that if the patient has a do-not-resuscitate order and a DNR bracelet, it remains valid if Section A says do not attempt CPR. MOLST orders are separate from advance directives such as a health care representative appointment or living will, and a patient may have both.