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Rhode Island Do Medical Orders for Life-Sustaining Treatment (MOLST)

A Rhode Island medical orders for life-sustaining treatment (MOLST) alerts health care professionals that a patient is refusing CPR in an emergency. The form below should be used by a patient who wishes to enroll in the MOLST program. A Standard DNR order can be obtained from a doctor, or another individual qualified to execute one.
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  • Laws – R23-4.11-MOLST
  • Required to Sign (MOLST) – Physician/RNP/APRN/PA and patient (or representative).

Sample