Compassion and Support


Patients & Families

MOLST & FHCDA - Professionals

MOLST and Family Health Care Decisions Act (FHCDA)

New York’s Family Health Care Decisions Act (FHCDA) establishes the authority of a patient’s family member or close friend to make health care decisions for the patient in cases where the patient lacks decisional capacity and did not leave prior instructions or appoint a health care agent.  The key provisions of the FHCDA became effective on June 1, 2010.  Under FHCDA, the surrogate decision-maker would also be empowered to make decisions regarding withdrawal or withholding of life-sustaining treatment when standards and procedures set forth in the statute are met.

New!  FHCDA 2994-a Subdivision 5-a and 17-a.  Decisions regarding hospice care, including the withdrawal or withholding of life-sustaining treatment, effective September 19, 2011!

The New York State Department of Health (NYSDOH) revised the MOLST form (DOH-5003) in June of 2010 to make it more user-friendly and to align the form with the procedures and decision-making standards set forth in the FHCDA. 
MOLST Instructions and Legal Requirements Checklists


MOLST Chart Documentation Forms


MOLST and FHCDA Educational Resources and Tools


  •  DOH-5003 MOLST form 
  • Printing the MOLST form on bright "pulsar" pink, heavy stock paper is strongly encouraged.
  • Astrobrights Pulsar Pink 24lb paper is available through Office Depot, Staples, Office Max, and other paper suppliers. 
  • When EMS personnel respond to an emergency call in the community, they are trained to check whether the patient has a pink MOLST form before initiating life-sustaining treatment.  They might not notice a MOLST form on plain white paper.
  • However, white MOLST forms and photocopies, faxes, or electronic representations of the original, signed MOLST are legal and valid.
  •   Spanish version of the MOLST form for educational purposes ONLY.

Key Resources

For more information on MOLST, view MOLST for Professionals and NYSDOH and MOLST.

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