When a Patient has a MOLST Form

Physicians, nurse practitioners and physician assistants 

• Check to see if the MOLST is valid. 
  • On Page 1, if Section D (patient information) and Section E (clinician information) are fully complete and legible, Page 1 of the form is valid. 
  • On Page 2, if Section G (patient information) and Section H (clinician information) are fully complete and legible, Page 2 of the form is valid. 
• Assess the clinical situation and honor the MOLST form when clinically appropriate.
• Contact the clinician who signed the MOLST for more information.
• Write orders to implement the MOLST instructions as appropriate for your clinical practice setting.
• Re-discuss and complete a new MOLST form with the patients as needed.

Emergency Medical Technicians

• Honor all valid MOLST forms per authority of the Massachusetts Department of Public Health Office of Emergency Medical Services (OEMS). 
• Call Medical Control with any questions about MOLST.

Nurses and other health care professionals 

• Honor MOLST instructions as you would honor other medical orders, until a physician, nurse practitioner or physician assistant can assess the clinical situation. 
• Alert a physican, nurse practitioner or physician assistant to the existence and content of patients' MOLST instructions.
• Contact the clinician who signed the MOLST for more information.