CDCR 7421- ADVANCE DIRECTIVE FOR HEALTH CARE
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This form documents an incarcerated person’s medical wishes for emergency and end-of-life care, such as whether they want CPR, breathing machines, or feeding tubes. The POLST is a medical order signed by a doctor, nurse practitioner, or physician assistant, and it must be followed by all health care providers.
It must be filled out with a doctor, nurse practitioner, or physician assistant, who will explain care options.
Once the person makes their choices, the provider signs the form to make it a legal medical order.
A copy is kept in their medical file and follows them if they’re transferred or hospitalized.
Filling out this form documents an incarcerated person’s medical wishes for emergency and end-of-life care.