POLST Communications

The MMA has been instrumental in developing a standardized Provider Orders for Life-Sustaining Treatment (POLST) form that can be used for patients diagnosed with serious illnesses throughout Minnesota.

The target audience for this form are patients diagnosed with serious illnesses such as those enrolled in hospice programs, living in nursing homes and using home care agencies.

The MMA recommends that physicians read both the instructions on the back of the form and the MMA's FAQ about the form before using it with patients.

More information about the form can be obtained by calling MMA Policy Counsel,
Teresa Knoedler at (612) 362-3738.

POLST Work Group Page.


POLST Resources

POLST Frequently Asked Questions

POLST PowerPoint Presentation

POLST Form (as endorsed by the MMA Board of Trustees and the Emergency Medical Services Regulatory Board)

POLST Form (which may be tailored to include a specific provider logo)


You will need to use Acrobat to "stamp" your logo into the document.

Click here for step-by-step instructions.


The Need for POLST: Minnesota’s Initiative, Minnesota Medicine, January 2010


Contents of the kit include:

  • One copy of the MMA-endorsed POLST form;
  • One copy of the Frequently Asked Questions sheet;
  • One copy of the article, The Need for POLST: Minnesota’s Initiative,
    Minnesota Medicine, January 2010


If you do not have access to a printer and need to have a hard copy of the items above mailed to you via U.S. mail, please click on the following link:
Request POLST kit

Additional Resources

Advance Directives

1300 Godward St. NE, Suite 2500, Minneapolis, MN 55413 | Phone: (612) 378-1875 | Fax: (612) 378-3875 | mma@mnmed.org
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