Oregon's portable medical order records CPR and medical intervention choices for people with serious illness or frailty. A signed Oregon POLST is submitted to the statewide Oregon POLST Registry unless the patient opts out, so EMS and hospitals can find it. The 2023 form, version 14, is current, and the program at OHSU supplies printed forms to health professionals and medical institutions.
An MD, DO, NP, PA or ND signs the Section E attestation with name, phone and date after documenting the discussion in Section C; a license number is optional. The patient acknowledgment in Section D is recommended but not required.
Download the current version from the source each time; forms change without notice.
Oregon POLST Form (Portable Orders for Life-Sustaining Treatment)
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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Yes, unless the patient opts out by checking the box in Section D. The signer's office submits the form, and the Registry mails a confirmation packet to the patient in about four weeks. If wishes have not changed at review, the form does not need to be rewritten or resent.
An MD, DO, NP, PA or ND. On the form, signed means a physical signature, an electronic signature or a verbal order documented per standard medical practice, as set out in Oregon's POLST administrative rule. Verbal or phone orders handled under facility or community policy can be submitted to the Registry.