Forms

Medical forms and information you may need:

• My Choices Advanced Directive - Use this form to detail your medical choices if you cannot make or communicate your health care decisions directly.

• Advanced Care Planning & completing your orders for life-sustaining treatment (POLST) - Use this informational one-sheet to help you complete your Orders for Life-Sustaining Treatment form (below).

• Montana Orders for Life-Sustaining Treatment (POLST) form - This form is to help you decide what kind of life-sustaining treatment you would like if you cannot communicate.

• Authorization for Disclosure of Health Information - Use this form to have your medical records released to another physician, or entity, or to have your medical records from another physician or location sent to us. Fax to: (406) 375-4660 or email to: MedicalRecordsRequest@bitterroothealth.org