What Is a POLST Form in Georgia and How Does It Work?

A POLST form in Georgia is a physician’s medical order that spells out which life-sustaining treatments a seriously ill patient wants, and which they do not. Short for Physician Orders for Life-Sustaining Treatment, it is signed by both the patient (or an authorized representative) and the attending physician, and it takes effect the moment it is signed. Paramedics, nurses, and hospital staff can act on it immediately, with the same authority as any other doctor’s order. The governing statute is O.C.G.A. 31-1-14.¹

Who Can Have a POLST in Georgia

A POLST is not a general planning document. Georgia law allows one only when a patient has a serious illness or condition and the attending physician’s reasoned medical judgment is that the patient will die within the next 365 days.¹ That is a clinical judgment the physician must be willing to make.

If you are healthy and simply want to plan ahead, a POLST is the wrong tool. The right document is a Georgia advance directive for health care, which any competent adult can sign regardless of health status.² The POLST exists for people whose current condition makes emergency treatment decisions foreseeable and urgent.

What the Form Decides

The Georgia POLST documents preferences across a few specific categories of care:

Whether emergency personnel should attempt CPR if the patient’s heart stops or breathing ceases.
The level of medical intervention wanted, from comfort-focused care only through full intensive care.
Whether to use artificial nutrition and hydration if the patient cannot eat or drink.

One line cannot be crossed. Medication to relieve pain, and any procedure necessary to alleviate pain, are never treated as “life-sustaining procedures” under the statute and cannot be withheld through a POLST.¹ Comfort care continues no matter what else the form says.

A practical warning: any section left blank defaults to full treatment for that category. Fill in the CPR section but leave the medical interventions section empty, and providers will give the full range of interventions until told otherwise. Blank is not “no.”

How to Sign a Valid POLST

A valid Georgia POLST needs two signatures: the patient (or the patient’s authorized person) and the attending physician. The statute defines “attending physician” as the physician with primary responsibility for the patient’s treatment and care at the time.¹ National POLST materials sometimes describe nurse practitioners or physician assistants co-signing, but the Georgia statute specifies a physician.

If the patient has decision-making capacity, they sign alongside the physician. Capacity, under the statute, means the patient understands the nature and consequences of the order, including the benefits and disadvantages, and can reach an informed decision.¹

When the patient lacks capacity, an “authorized person” may sign. The statute pulls that definition from O.C.G.A. 31-39-2, which generally covers a healthcare agent named in an advance directive, a legal guardian, or certain family members with authority to make healthcare decisions. Signing is always voluntary; no one can be compelled to execute a POLST.

Photocopies and faxes of a signed POLST are legally valid in Georgia. That matters when the original has to travel between a home, a hospital, and a nursing facility.

Changing or Revoking the Form

Because a POLST is a physician’s order rather than a personal document, a patient cannot simply cross out a line and initial the change. The form remains in effect until it is revoked by the attending physician with the consent of the patient or the authorized person.¹ Updating the form means going back to a physician and creating a new one.

Good practice is to review the POLST at least once a year, and sooner whenever something significant shifts: a new diagnosis, a notable decline or improvement, or a move from one care setting to another. Each of those moments can change what treatments actually match the patient’s goals.

What Happens When Paramedics Arrive

The real test comes when 911 is called. In Georgia, EMS crews will check for an out-of-hospital DNR order or a POLST. A POLST that indicates “allow natural death” or “do not resuscitate” functions as a DNR instruction, giving EMS permission not to perform CPR.¹ Without either document, crews are legally required to attempt resuscitation.

The POLST does more than a bare DNR. It can also direct whether to use mechanical ventilation, whether to transport to a hospital, and what level of intervention to provide. Paramedics get a fuller picture than a standalone DNR gives them.

None of that helps if the form cannot be found. For patients at home, keeping the signed POLST on the refrigerator door or in another prominent location is the usual recommendation. In care facilities, it belongs in the patient’s medical record where staff can reach it immediately. A POLST filed somewhere obscure serves no one in a crisis.

If a Provider Refuses to Follow Your POLST

Not every provider will honor every POLST. Georgia law allows a provider or facility to decline, but imposes real obligations when they do. The provider must promptly inform the patient or authorized person of the refusal, and the authorized person then becomes responsible for arranging a transfer to a willing provider or facility.¹

During the transfer, the refusing provider must continue to provide reasonably necessary consultation and care until the handoff is complete. A provider who refuses, communicates promptly, and cooperates with the transfer has civil and criminal immunity so long as their actions substantially accord with reasonable medical standards.¹ A provider who simply ignores the form, without going through the refusal-and-transfer process, has no immunity to fall back on.

Why Providers Follow a Signed POLST

The statute gives healthcare providers broad protection, which is why they can act on these orders without hesitation. Anyone who acts in good faith reliance on a POLST is protected as if they had dealt directly with the patient as a fully competent person.³ No provider faces civil liability, criminal liability, or professional discipline solely for following end-of-life decisions documented in a POLST, even if death or injury results.¹ A provider who relies on a POLST without knowing it has been revoked is also protected; liability only attaches with actual knowledge of the revocation.

These protections exist because POLST orders sometimes put providers in the position of withholding treatment that a family member is asking for, or offering only comfort care when aggressive intervention is technically available. Without legal cover, many providers would default to maximum treatment.

POLST and Advance Directive: Two Different Documents

Georgians often mix up POLSTs and advance directives. They cover related subject matter, but they do different jobs.

An advance directive for health care, under O.C.G.A. Chapter 31-32, is a broader legal document any competent adult can execute at any time.² It typically names a healthcare agent and lays out general preferences about life-sustaining care. It activates only when the patient loses the ability to make decisions.

A POLST is a current physician’s order. It takes effect the moment it is signed, works in emergencies where there is no time to find and interpret an advance directive, and is only for patients whose physician believes they may die within a year. EMS personnel are trained to look for POLSTs; they generally cannot act on the broader language of an advance directive during a crisis.

The two documents work best together. The advance directive names the person who will speak for you and establishes your values. The POLST translates those values into specific medical orders for your current condition.

When the Documents Conflict

If a patient’s POLST says one thing and their advance directive says another, Georgia law has a tiebreaker: the most recently executed document controls to the extent of the conflict.¹ That rule covers living wills, durable powers of attorney for health care, and DNR orders as well. Each time you sign a new POLST, check that it still lines up with your advance directive, or update the advance directive to match.

Keeping the Form Where It Will Be Found

Georgia does not maintain a statewide electronic POLST registry that EMS or hospitals can query in real time. The physical form, or a valid photocopy or fax, is still how these orders travel with the patient. If you move between settings, whether from home to a hospital or between facilities, make sure a current copy of your POLST goes with you. Until an electronic registry exists, the burden of making the form findable sits with patients, families, and care facilities.

1
Justia. Georgia Code 31-1-14 – Physician Orders for Life-Sustaining Treatment
2
Georgia Department of Community Health. Georgia Advance Directive for Health Care
3
Georgia Department of Public Health. Physician Orders For Life-Sustaining Treatment (POLST)