The DC MOST Form is made publically available on our website where it may be downloaded and printed. It is advsied that, the form should be printed on bright colored paper (i.e. bright blue paper) so that it can be easily located and differentiated from other medical documents in the event of a medical emergency, and to alert first responders, EMS, and other healthcare providers that the patient participates in the MOST program. 

All copies of the original MOST Form serve as a legal document. The healthcare provider must keep an original or copy in the patient medical record. The patient must have a copy on their person or in the immediate visible vicinity in order for it to be honored. 

Portability

A copy of the patient’s MOST form should follow the patient in any setting and must be honored.  This includes, but is not limited to: hospitals, long-term care facilities, clinics, hospice, private medical practices, and the patient’s home. The portability of the form provides continuity and assurance that if the patient is incapacitated and transferred to a new health care setting, the patient’s End-of-Life wishes will be easily recognized and respected.  It is required that, within seventy-two (72) hours of the patient’s transfer to a healthcare setting, that the MOST form be reviewed by an authorized DC-licensed healthcare provider. 

Revocation of MOST

The MOST form may be revoked at any time by the patient or patient’s authorized representative.  To cancel the form, write the words “VOID” across the form and put a line through “Medical Orders for Scope of Treatment” at the top of the page.  Revocation can also occur verbally to EMS responders or an authorized DC-licensed healthcare provider.  Following the revocation, the patient’s medical record should be updated accordingly.