The current Massachusetts MOLST form was posted August 10, 2013.

Please Note: All previously posted versions of the MOLST form remain valid. 

Download the CURRENT Massachusetts MOLST form See the Clinician Checklist for MOLST use with patients. (Download a sample checklist) View samples of previous, still valid, versions of the MOLST form

Instructions for printing the MOLST form:

1. Download the standardized form found on the MOLST web site. Do not alter the MOLST form.  EMTs have been trained to recognize and honor the standardized MOLST form. 
2. Print MOLST forms on bright or fluorescent pink paper for maximum visibility.  Astrobrights® Pulsar Pink is the color highly recommended for original MOLST forms.  EMTs are trained to look for the bright pink MOLST form before initiating life‐sustaining treatment with patients.   
3. Print the MOLST form (pages 1 and 2) as a double-sided form on a single sheet of paper.
4. Provide an electronic version of the downloaded MOLST form to your institution’s forms department or to personnel responsible for copying/providing forms in your institution.