Alaska Most Form Medical Orders For Scope Of Treatment Page 4

Reviewing and Revising the MOST form:

Consider reviewing or revising the MOST form periodically if:

(1) The person is transferred from one care setting or care level to another, or

(2) There is a substantial change in the person’s health status, or

(3) The person’s treatment preferences change.

________________________________________________________________________________________

This MOST form supersedes any prior MOST forms. A health care provider should void any prior MOST

form by drawing a line through its sections A – E, writing “VOID” in large letters and then signing and dating

on the line. If a MOST form is voided without creating a new MOST form, full treatment and resuscitation

may be provided.

June 2011

Page 4 of 2

This MOST form must accompany person when transferred or discharged.

Alaska MOST Task Force

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Parent category: Legal