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FAQs About who (health professionals) should sign patients’ MOLST forms:

Who fills out the MOLST form?
A clinician (physician, nurse practitioner, or physician assistant) and the person with advanced illness (or their health care agent, if the person lacks capacity).


Which types of clinicians can sign a MOLST form?

In Massachusetts, MOLST forms can be signed by physicians, nurse practitioners or physician assistants.  However, clinicians may be limited in their scope of practice (e.g. not able to sign MOLST forms) in some situations, according to the specifications of their practice setting.  It is a clinician’s responsibility to know if their scope of practice includes completing a MOLST form with a patient.  By signing a patient’s MOLST form, the clinician attests that the contents of the MOLST form reflect the patient’s decisions based on their discussion with the patient.


Why shouldn’t blank MOLST forms be given to or mailed to patients or their family members to preview or consider on their own?

The MOLST form is a standardized medical order form that relays instructions from one licensed health professional to another.  It should be filled out by a health professional, after discussions between a clinician and patient about the patient's prognosis, treatments and goals of care.  The MOLST form should not be used to introduce or solicit patient decisions about life-sustaining treatments.   It is designed only for documenting decisions patients make in the context of appropriate discussions about life-sustaining treatment choices with a clinician.


Can a facility Medical Director sign a patient’s MOLST form?

Yes, but only if the Medical Director is a physician, nurse practitioner, or physician assistant and is the clinician who personally discussed MOLST choices with the patient.


Who keeps the signed MOLST form?

The person with advanced illness keeps the MOLST form with them, in a place where it is easy to locate (e.g. on the refrigerator, beside the bed, or on the door), and it should be carried with them outside the home. Copies of MOLST forms are also valid and should be given to the person's health care agent and primary care provider.

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