Forms

A POST is a physician-signed order form which communicates and puts into action treatment preferences when a patient is near the end of their life. The Virginia POST form was modeled after the Oregon POLST form which has been in use for almost 20 years.

POST is for those with a terminal illness, or those dealing with a chronic progressive illness, like advanced heart or lung disease or cancer, that has spread.  Those who are frail and elderly may benefit from a POST, as well.

The POST form should be completed only after the patient (or, if the patient lacks capacity, the patient’s health care agent) has an advance care planning discussion with a physician or a trained POST Advance Care Planning Facilitator (ACPF) under the direction of a physician.

Patients and families interested in creating a POST form should do so through their health care provider. You may also contact us and we will help direct you to someone in your area who can help you create a POST.

Health care professionals or organizations interested in POST may contact us for further information.

 

Sample POST Form  This is a sample form only and not intended for clinical use. Official forms must be obtained from your physician. Physicians: Please note that not all regions of Virginia have implemented the POST program. If POST forms are not available in your area yet, we would love to work with you to implement POST in your community. 

Call us today at 703-957-1763

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© 2016 Virginia POST Collaborative