South Carolina POST Form (POLST): What It Is and How to Get One

South Carolina calls it the POST form — Physician Orders for Scope of Treatment — not POLST (Physician Orders for Life-Sustaining Treatment), though both serve the same purpose. The form (D-4061, issued by the Department of Public Health) translates your treatment preferences into actionable medical orders that follow you across every care setting.

Unlike a living will, which is a legal document you create yourself, the POST form is a medical order. It must be initiated through a conversation with your physician, APRN, or PA, and it requires their signature alongside yours.

Who Qualifies for a POST Form

The POST form is designed for people with serious, life-limiting illness or advanced frailty — not for healthy adults doing routine advance planning. Your physician will discuss a POST form if:

• You have a terminal diagnosis
• You have an advanced chronic condition (late-stage heart failure, advanced COPD, end-stage renal disease)
• You have advanced frailty or progressive cognitive decline
• You're transitioning to hospice or palliative care

If you're a healthy adult planning ahead, a Healthcare Power of Attorney and living will are the appropriate documents. The POST form is for when your medical situation has progressed to the point where specific treatment orders need to be in place across settings.

What the POST Form Covers

The POST form addresses a broader range of treatment decisions than either a living will or a DNR order:

• Resuscitation — attempt CPR or do not attempt
• Medical interventions — full treatment, selective treatment, or comfort-focused treatment
• Antibiotics — full course, limited use, or comfort only
• IV fluids — long-term, trial period, or none
• Artificially administered nutrition — long-term, trial period, or none
• Hospital transfer — when and under what conditions

Each section lets you specify your preferences at a level of detail that a living will can't match. And because it's a medical order (not just a legal document), healthcare providers must follow it as they would any physician order.

POST vs. Living Will vs. DNR

The POST form doesn't replace your living will or Healthcare Power of Attorney — it complements them. Your advance directive establishes the legal framework and names your decision-maker. The POST form translates your specific wishes into standing medical orders that providers follow immediately.

The South Carolina POST eRegistry

South Carolina operates a secure, HIPAA-compliant online eRegistry through the South Carolina Care for the Seriously Ill (CSI) Coalition (My Life My Choices). Once your POST form is completed, it can be submitted to the registry for immediate electronic retrieval by emergency responders and hospital systems.

This is particularly valuable for EMS calls. Paramedics can query the registry to verify your treatment orders before they arrive at your home — no paper form needed.

How to Get a POST Form

1. Initiate the conversation with your treating physician, PA, or APRN about your treatment goals
2. Your clinician completes Form D-4061 based on the discussion
3. Both you and your clinician sign — or your legally authorized representative signs if you lack capacity
4. Submit to the eRegistry for electronic access by responders
5. Keep the original form accessible — post it visibly at home if you're receiving home care

Make sure your POST form is consistent with your advance directive. If your living will says to withhold life-sustaining treatment but your POST form says to provide full interventions, the conflicting instructions will create confusion at exactly the wrong moment.

The South Carolina Advance Directive & Living Will Kit includes guidance on coordinating your POST form with your living will and Healthcare Power of Attorney so all documents work together without contradictions.

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