Medical Orders for Life-Sustaining Treatment - Professionals
MOLST: Supplemental Documentation Form for Minors
MOLST: Supplemental Documentation Form for Minors contains the documentation requirements outlined by the 1988 New York State legislation governing do-not-resuscitate (DNR) orders.
If MOLST is completed for patients/residents under 18 years old who are not married and/or are not a parent, the MOLST: Supplemental Documentation Form for Minors must be completed as well. Patients/residents under 18 who are married and/or are parents are treated as adults under New York State law. A lawyer should be contacted if there is any uncertainty about the situation.
As per Public Health Law §2967(4)(b), a parent may give a verbal consent in the presence of 2 witnesses one of whom must be a physician affiliated with the hospital in which the patient is being treated. The decision must be noted in the patient's medical chart.
The MOLST: Supplemental Documentation Form for Minors is a supplement to the MOLST form and should be kept with it at all times.
NOTE: After completing the MOLST: Supplemental Documentation Form for Minors, please check the corresponding box in Section B of the original MOLST form.
To view, download a printable sample of the MOLST: Supplemental Documentation Form for Minors. [pdf]
