To fill out the Iowa IPOST form, an eligible patient (or their legal representative) sits down with a physician, physician assistant, or advanced registered nurse practitioner, makes a choice in each of the three clinical sections, and signs and dates the form alongside the clinician. Every section must be marked, because Iowa law treats any blank section as a request for full treatment in that category of care.1Iowa Legislature. Iowa Code 144D.2 – Physician Orders for Scope of Treatment (POST) Form The official one-page, double-sided form is a free PDF download from the Iowa Department of Health and Human Services.2Health & Human Services. Iowa Physician Orders for Scope of Treatment (IPOST)
Confirm the Patient Is Eligible
Before the form is completed, the clinician confirms the patient qualifies. Iowa law limits the IPOST to patients who are frail and elderly, who have a chronic or critical medical condition, or who have a terminal illness, and for whom the orders match the patient’s overall goals of care.3Iowa Legislature. Iowa Code 144D – Physician Orders for Scope of Treatment Age by itself is not enough. Healthy adults who want to document care preferences should use a living will or durable power of attorney for health care instead.
Use the Official Form
Download the current form from hhs.iowa.gov/ipost, or ask for a copy at a hospital, hospice program, or skilled nursing facility.2Health & Human Services. Iowa Physician Orders for Scope of Treatment (IPOST) The form is prescribed by the Iowa Department of Health and Human Services and is standardized statewide, so every valid IPOST looks the same no matter where you obtain it.1Iowa Legislature. Iowa Code 144D.2 – Physician Orders for Scope of Treatment (POST) Form Fill in the patient identification fields at the top before moving to the clinical sections.
Section A: CPR
Section A applies only when the patient has no pulse and is not breathing. Check one of two boxes: “CPR/Attempt Resuscitation” or “DNR/Do Not Attempt Resuscitation.”4Iowa Department of Health and Human Services. Iowa Physician Orders for Scope of Treatment A DNR choice directs responders toward comfort rather than chest compressions or defibrillation. A CPR choice means full resuscitation efforts proceed as they would for any patient.
Section B: Medical Interventions
Section B covers care when the patient still has a pulse or is still breathing but needs emergency treatment. Choose one of three tiers:4Iowa Department of Health and Human Services. Iowa Physician Orders for Scope of Treatment
- Comfort Measures Only. Medication for pain and suffering, oxygen and suctioning for comfort, wound care, and positioning. No hospital transfer for life-sustaining treatment, though the patient can be transferred if comfort needs cannot be met in the current location.
- Limited Additional Interventions. Everything in comfort measures, plus IV fluids, cardiac monitoring, oral medications, and non-invasive airway support such as BiPAP or CPAP. No intubation or mechanical ventilation. Hospital transfer and critical care are available if needed.
- Full Treatment. All available interventions, including intubation, mechanical ventilation, advanced airway management, and cardioversion. Hospital transfer and critical care are included.
The line between Limited Additional Interventions and Full Treatment comes down to whether the patient wants to be placed on a ventilator. Talk through realistic outcomes with the signing clinician before checking a box.
Section C: Artificially Administered Nutrition
Section C addresses feeding tubes for patients who can no longer eat or drink by mouth. The form always assumes food will be offered orally if feasible. The three choices are:4Iowa Department of Health and Human Services. Iowa Physician Orders for Scope of Treatment
- No artificial nutrition by tube.
- Defined trial period of artificial nutrition by tube.
- Long-term artificial nutrition by tube.
The defined trial period is a middle option that lets the care team try tube feeding for a limited time and stop if the patient’s condition does not improve, without needing a new form. The trial period itself is the authorization.
Signatures That Make It a Valid Order
The form requires signatures and dates from two parties: the patient (or the patient’s legal representative) and the patient’s physician, physician assistant, or advanced registered nurse practitioner. If a social worker, nurse, or anyone else facilitated the conversation without being the signing clinician, that facilitator must also sign and date the form.1Iowa Legislature. Iowa Code 144D.2 – Physician Orders for Scope of Treatment (POST) Form Missing any required signature means the form is not a valid medical order.
A legal representative, under Iowa law, is someone authorized to act for a patient who is not competent to make their own decisions, following the priority order in Iowa Code Section 144A.7. The representative is guided by the patient’s known wishes or, when those are unknown, by the patient’s best interests given their medical condition.3Iowa Legislature. Iowa Code 144D – Physician Orders for Scope of Treatment
Even if the patient wants full treatment in every category, mark each box deliberately rather than leaving sections blank. The default-to-full-treatment rule is designed to be safe, but an unmarked form invites questions about whether the conversation actually happened for that section.
Check Against Other Advance Directives Before Signing
An IPOST works alongside a living will or durable power of attorney for health care; it does not replace them, and those earlier documents control if there is a conflict. Iowa Code Section 144D.4 provides that a POST form cannot supersede a declaration (living will) executed under Chapter 144A or a durable power of attorney for health care executed under Chapter 144B. An out-of-hospital do-not-resuscitate order issued under Section 144A.7A also controls over the IPOST.5Iowa Legislature. Iowa Code 144D.4 – General Provisions Bring copies of any existing directives to the IPOST conversation so the signing clinician can catch inconsistencies before the form is finalized.
Changing or Revoking the Form Later
A patient or legal representative can revoke the IPOST at any time, in any way they are able to communicate — verbally, in writing, or by any other means — regardless of the patient’s mental or physical condition. The revocation takes effect as to a specific provider, hospital, or facility only once that provider actually receives the communication, whether from the patient, the legal representative, or someone the patient told about the revocation.6Iowa Legislature. Iowa Code 144D.3 – Compliance with POST Form Until that communication reaches the care team, they may continue to follow the existing orders in good faith.
To change specific choices, a brand-new IPOST must be completed with fresh signatures and a new date. Iowa law does not allow amending a single section; the whole form is replaced. Once a new form is signed, destroy the old one or clearly mark it void, and make sure every provider, facility, and family member who had the old version receives the replacement or knows the previous version no longer applies.