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An Introduction to the Oregon POLST Registry


  • pg 1
									The Oregon POLST Registry
Information for patients and families
What is the Oregon POLST Registry
• It is a secure electronic record of
  your POLST orders
• The Registry allows emergency
  medical professionals access to
  your POLST orders if the original
  POLST form cannot be found
• The Registry is a back-up system
  and does not replace your
  original POLST form
How does the Registry work?

• If, in an emergency, your POLST form cannot be immediately
  found, emergency medical professionals can call the Registry
  to obtain your orders
How will the Registry get my form?
• The health care professional who signed
  your form is required to submit your form
  to the Registry (unless you opt-out)

• You can also fax or mail a copy of your
  form to the Registry:
  ▫ Registry fax: 503-418-2161
  ▫ Oregon POLST Registry
    3181 SW Sam Jackson Park Rd
    Portland, OR 97239
What if I don’t want my information in the
• If you don’t want your information in the Registry
  simply check the ‘opt-out’ box on your form

• If your form was entered into the Registry and you
  would like it removed, contact us!
   ▫ Phone: 503-418-4083
   ▫ Toll free: 877-367-7657
   ▫ E-mail:
   ▫ Submit a web request:
How will I know my form is in the Registry?
 • A confirmation letter will be mailed to you if mailing
   address information was included with your POLST

 • Your confirmation packet will contain a Oregon
   POLST Registry magnet and set of stickers with your
   unique Registry ID printed on them
   ▫ The Registry ID is unique and helps identify your form
     in the Registry, please refer to this ID any time you call
     the Registry
Confirmation letter
• To the right is an
  example of a
  confirmation letter

• The letter includes:
  ▫ Your Registry ID
  ▫ A synopsis of your
    section A and section B
  ▫ Information on how to
    contact the Registry
Registry Magnets and Stickers
• The magnet and stickers are used to
  alert health care professionals that
  you have a POLST form on file with
  the Registry

• POLST Registry magnets and stickers
  do not replace the original POLST
Where do I put my magnet and stickers?
• The Registry magnet (example right)
  should be placed on your refrigerator

• It is recommended that you place
  your stickers:
   ▫ On your original POLST form
   ▫ On something you carry with you
     (ex. your wallet)
   ▫ The third can be given to your
     primary care provider
Can I get additional magnets and stickers?
• Yes! The Registry office is happy to provide you with
  additional magnets, stickers, and even copies of your
  POLST form

• To request additional materials:
  ▫   Phone: 503-418-4083
  ▫   Toll free: 877-367-7657
  ▫   E-mail:
  ▫   Submit a web request:
Contact the Registry:
• When your POLST orders change

• When your personal information changes (address,
  name, etc.)

• When you have questions about the Registry

                We are here to help!
How to contact the Registry
•   Phone: 503-418-4083
•   Toll free: 877-367-7657
•   Fax: 503-418-2161
•   E-mail:
•   Website:

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