Compassion and Support


Patients & Families

Medical Orders for Life Sustaining Treatment - Patients & Families

MOLST Program

The Medical Orders for Life-Sustaining Treatment (MOLST) Program is designed to improve the quality of care people receive at the end of life.  MOLST is New York State's Physicians Orders for Life-Sustaining Treatment (POLST) Paradigm Program.  These programs are based on effective communication of patient wishes, documentation of medical orders on a brightly colored form, and a promise by health care professionals to honor these wishes.  See if your state has a POLST Paradigm Program

The MOLST Program

  • Assists health care professionals discuss and develop treatment plans that reflect patient wishes.
  • Results in the completion of the MOLST form.
  • Helps physicians, nurses, health care facilities and emergency personnel honor patient wishes regarding life-sustaining treatments. 

The MOLST Form  

  •    DOH-5003 MOLST form
  •  A copy of the form on bright pink paper is legally valid. 
  • The reason to send a copy and retain the original is to prevent the original from being lost in a patient's transfer from one healthcare copy possible.
  •   Spanish version of the MOLST form for educational purposes ONLY.

MOLST is based on communication between the patient or decision-maker and health care professionals to ensure shared, informed medical decision-making based on the patient's goals for care.  Read more about the MOLST Discussion.


  • Patients, families and persons who make decisions on behalf of those who have lost the ability to decide often have questions about MOLST.  View the MOLST FAQs for Patients and Families.
  • For additional information read the Advance Care Planning Booklet found HERE.