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Oregon POLST Registry Information

The Oregon POLST Registry is an electronic record of POLST forms designed to provide  POLST orders to Emergency Medical Services (EMS) if the POLST form cannot be immediately found. 

The Registry is housed at OHSU behind a protective firewall keeping this health information secure and confidential.  All patients with Oregon POLST forms are encouraged to submit both sides of their completed and signed form to the Registry.  Unless the patient opts out of the Registry, forms can be faxed or mailed by the patient, surrogate or health care professional directly to the Registry office.

How to Submit a POLST form to the Oregon POLST Registry

 

2008 or newer versions of POLST

In August 2008 the POLST form was revised to include an expanded demographics box which allows for more personal identifying information to be included on the form.  Submitting these forms to the Registry is simple.

Step 1.  Fill out the form

Step 2.  Confirm these required items are completed:

  • Full name (first, mi, last)

  • Date of birth

  • Section A order selection

  • Professional signature AND date signed

Step 3.  Fax or mail a copy of the front AND back sides of the POLST form to the Registry office.  FAX or eFAX: 503-418-2161Please provide a fax coversheet with contact information in case we have any questions

PLEASE NOTE: POLST forms should photocopy into black & white documents without distortion.  If you are unable to photocopy a POLST form it may be on the incorrect color of paper.  Please contact the POLST office for more information: polst@ohsu.edu or 503-494-9365. 

Patients may opt out of the Registry by checking the "opt out" box on the reverse side of the form.  If the patient does not opt out their POLST form must be submitted to the Registry. 

Click here for POLST Registry contact information. 

 

Any form version prior to 2008

If a person already has a POLST form, and the orders on the form are still their current wishes, it can, and should, be submitted to the Registry.  The additional demographics form needs to be completed and sent along with the POLST form copy that is faxed to the registryClick here for the Demographics form.

 

Return to Oregon POLST Registry Page>>

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