The Alabama Department of Public Health's palliative care resources link the National POLST Form, a portable medical order for patients at risk of a life-threatening event from a serious life-limiting condition, including advanced frailty. After a goals-of-care conversation, the provider records CPR orders, initial treatment level, additional orders and medically assisted nutrition, and the patient keeps the original.
A physician, nurse practitioner or physician assistant completes Sections A through D with the patient or surrogate and signs Section F, which is limited to providers authorized by state law to sign POLST. The patient or surrogate signs Section E.
Download the current version from the source each time; forms change without notice.
National POLST Form (Alabama)
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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No. The form does not expire, but it should be reviewed when the patient moves between care settings or levels, has a substantial change in health, changes primary provider, or changes treatment preferences or goals. The most recently completed valid POLST supersedes all previously completed forms.
No. The National POLST Form should be obtained from a health care provider and is not to be given to patients or surrogates to complete. Providers complete it only after a conversation with the patient or surrogate, and verbal orders are acceptable with a follow-up signature.