Varies by state · State Legislatures / State Bar Associations
Written declaration of preferences regarding life-sustaining treatment, artificial nutrition and hydration, and comfort care when terminally ill or permanently unconscious. Legally distinct from healthcare proxy in many states.
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Keep originals with your healthcare agent and physician
Most states require witnesses and/or notarization. Provide copies to your doctors, hospital, family, and attorney.
Upload to your state's advance directive registry (if available)
https://www.nhpco.org/advancedirective/Not all states have registries. Check your state's requirements.
Filing Deadline
No deadline — complete while you have decision-making capacity. Can be revoked or updated at any time.
Immediate upon proper execution. Ensure copies are distributed to all relevant parties.
Distribute copies to your healthcare agent, physicians, local hospital, family members, and attorney. Keep the original in an accessible (not locked) location.
State-specific · State Law (forms from AARP, state bar associations, hospitals)
Legal document specifying medical treatment preferences when the individual is unable to make decisions. Requirements for witnesses and notarization vary by state. Free state-specific forms available from AARP and state agencies.
State-specific · State Law
Designates a trusted person (agent/proxy) to make healthcare decisions when the individual cannot. May be part of a combined advance directive or a separate document depending on state law.
POLST · State Health Departments (46 states as of 2026)
Medical order (not just a directive) specifying life-sustaining treatment preferences. Actionable by EMS. For patients with serious life-limiting illness or advanced frailty. Works alongside advance directives.
MOLST · State Health Departments (e.g., New York)
New York's version of POLST. The only authorized form in NY for documenting non-hospital DNR and DNI orders. Must be completed by a physician in consultation with the patient or surrogate.
MOST / POST / COLST · Various State Health Departments
State-specific variants of POLST: Medical Orders for Scope of Treatment (MOST), Physician Orders for Scope of Treatment (POST), Clinician Orders for Life-Sustaining Treatment (COLST). Functionally equivalent to POLST.
DNR (state-specific) · State Departments of Health
Medical order directing healthcare providers not to perform CPR if the patient's heart stops or they stop breathing. Cannot be created by the patient alone; requires physician signature. Comfort care always continues.
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