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Changes to Medical Orders for Life-Sustaining Treatment (MOLST) Form (DOH-5003) (DAL DHCBS 25-04)

New Yorksub_regulatoryNYSDOH (multi-division: DHDTC/DACF/DHCBS/DNH/DEMS)· effective 2025-05-01

What this rule requires your agency to do

1Existing completed MOLST forms remain valid and continue to be honored.(Changes to Medical Orders for Life-Sustaining Treatment (MOLST) Form (DOH-5003) (DAL DHCBS 25-04))
2Under PHL Article 29-CCC, the MOLST (DOH-5003) is the only authorized New York State form for nonhospital DNR and DNI orders, and all health care professionals (including EMS) must follow these orders.(Changes to Medical Orders for Life-Sustaining Treatment (MOLST) Form (DOH-5003) (DAL DHCBS 25-04))

Applies to: cross-cutting

Describes revisions to the MOLST form (DOH-5003) and confirms the MOLST is the only authorized NYS form for nonhospital DNR and DNI orders.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.