The MOLST form is a bright pink medical order form signed by a New York State licensed physician that communicates patient wishes regarding life-sustaining treatment to health care providers. The form includes medical orders and patient preferences regarding:

• CPR (cardiopulmonary resuscitation)
• Intubation and mechanical ventilation
• Artificial hydration and nutrition
• Future hospitalization and transfer
• Antibiotics

The MOLST provides a single document that functions as an actionable medical order and can transition with a patient through all health care settings. It is intended that the form will be transported with the patient between different health care settings in order that their wishes for life-sustaining treatment and CPR will be clearly indicated. A copy (in white, not pink) can be downloaded here, but can only be completed by a physician.