Obtaining POLST Forms:

 

We no longer print POST or POLST forms.  Please contact us regarding how to obtain blank POLST forms.

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Requirements before obtaining the newly adopted National POLST form with Virginia-specific info on page 2:  

 

• Physician offices please contact us to obtain three guidance documents

• Hospital facilities should have at least two trained facilitators, hospital providers should have attended PCP training, and floor staff should attend a brief 20 minute introduction to POLST.

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All other facilities, please contact us for questions regarding your care setting.

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Virginia recently adopted (2022-2023) the National POLST form.  This form is available in a fillable .pdf version free of charge (after meeting the above requirements).  See sample National POLST form.  Please contact us for details.

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The Virginia POST form was last revised in 2017.  We no longer offer this form for purchase.  See revised sample form.  This document provides a summary of the changes.

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The copyright date at the bottom of the form is used to distinguish the different versions of POST.  Any Virginia POST form currently in use by a patient is still valid.

 

POST Forms are distributed by the Virginia POLST Collaborative through the Virginia POLST Administrative Home, Capital Caring Health.

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