Iowa's double-sided IPOST sheet, established under Iowa Code chapter 144D, records treatment preferences for people who are frail elderly or have a chronic critical condition or terminal illness. The clinician records CPR status, comfort measures, limited interventions or full treatment, artificial nutrition by tube, who directed the decisions and the rationale. The form belongs to the person and must accompany every transfer.
A physician, ARNP or PA completes Sections A through D and signs; the patient or legal surrogate also signs. A facilitator who prepares the form records their name and title.
Download the current version from the source each time; forms change without notice.
Iowa Physician Orders for Scope of Treatment (IPOST)
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
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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Iowa Code 144D requires dated signatures from the patient or legal representative and from the patient's physician, advanced registered nurse practitioner or physician assistant. If someone else prepared the form, the facilitator also signs. Verbal orders are acceptable with a follow-up clinician signature under facility policy.
A person with capacity, or a valid surrogate, can void the form and request other treatment. Draw a line through Sections A through C, write VOID in large letters across the form, and sign and date the line. Any change requires a new IPOST.