The New Jersey POLST Form

The Practitioners Orders for Life Sustaining Treatment, or POLST form, must be filled by a doctor or nurse with a patient or decision maker. The POLST form tells the medical team what to do for a patient who is seriously ill or approaching the end of life. The form expresses the individual’s wishes about the specific types of care he or she would and would not like to receive. The NJ POLST form gives specific care instructions related to a patient’s personal goals of care, artificial nutrition, resuscitation and re-hospitalization.

This form should travel with a patient if they are moving between medical facilities; be in a visible place at home; and be in the chart of a hospitalized patient. The physicians who care for a patient should have a copy as well as appropriate family members or friends.

NJ POLST videos series

Learn why this form is important, how it’s different from an advance directive, explore topics relevant to completing the form with a healthcare provider, and more.

4Step iCare Plan

An Individualized End of Life Care Plan

Our 4Step iCare Plan is a simple, 4-step approach that helps patients, families, and healthcare providers navigate through challenging medical decisions.
Learn more with our video series and helpful tools

Get Involved!

 As an agent of change. Join the Goals of Care Coalition of New Jersey to help improve end of life care for patients and families.
As a supporter of our efforts. We depend on the generosity of our donors to provide critical information to patients and families—this information is provided at no cost when it’s needed most.

GOCC Resources:

NJ POLST Form Videos and Documents
NJ POLST Form Videos and Documents