- Document Name
- MOLST (Medical orders for life sustaining treatments) has taken the place of the Comfort Care/Do Not Resuscitate Verification. However, existing DNRs will be honored.
- Where do you get the form
- You can find it on the mass.gov site or you can get it from your physician.
- Who signs the form
- The form is signed by the physician, a nurse practitioner or a physician’s assistant and the patient.
Who can request the form
Any adult can complete a MOLST form.
- Patient Identification
- The Comfort Care/DNR verification is the only document that EMS personnel can use to verify a DNR order is valid. If a person has a MOLST, the form itself can be used.
- How do you obtain a DNR or MOLST bracelet
- Your physician must order a DNR bracelet for you. The MOLST application contains bracelet inserts that can be used in generic wrist bracelets.
- Revoking a DNR or MOLST
- An EMS/DNR Order or MOLST may be revoked at any time.
- Photocopy
- Photocopies of the form or the bracelet inserts are considered authentic DNR or MOLST documents. Because EMTs are trained to look for a bright pink form in outpatient settings, it is highly recommended that a bright pink-colored DNR or MOLST form stays with the patient at all times.
- State info link
- http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/oems/comfort-care/
- http://www.molst-ma.org/
- Other links
- http://www.vialoflife.com/
- DNR Bracelet links
- Your physician must order a DNR braclet on your behalf.
- Special Notes
- Order a Vial of Life decal for your front door. The decal informs Emergency Medical Services team a DNR or MOLST has been prepared and can be found in your refrigerator.