MOST Form Colorado: Medical Orders for Scope of Treatment

Your parent is in the hospital after a fall. The doctor asks whether they want full resuscitation, comfort care only, or something in between. Nobody knows what your parent would choose — and without a MOST form, the medical team defaults to the most aggressive interventions regardless of your parent's actual wishes.

Colorado's Medical Orders for Scope of Treatment (MOST) form translates your parent's treatment preferences into actionable medical orders that travel with them across every care setting.

What the MOST Form Is (and Isn't)

The MOST form, governed by C.R.S. § 15-18.7-108, is a portable medical order — not a planning document. Unlike a living will or advance directive that expresses general wishes, the MOST form contains specific physician orders that emergency responders, nurses, and hospital staff must follow.

It covers three critical decisions:

Cardiopulmonary resuscitation (CPR). Whether to attempt resuscitation if the patient's heart stops or they stop breathing.

Medical interventions. The level of treatment desired — full treatment (ICU, intubation, mechanical ventilation), selective treatment (IV fluids and medications but avoid intubation), or comfort-focused treatment (pain management and symptom relief only).

Artificially administered nutrition. Whether to provide nutrition through a feeding tube if the patient can no longer eat or drink.

Who Can Complete the MOST Form

The MOST form requires two signatures:

1. The patient or their legal surrogate — if the parent has decisional capacity, they sign. If capacity is lost, the healthcare agent named in a Medical Durable Power of Attorney (MDPOA) can sign on their behalf. This is one of the few Colorado medical documents that a surrogate can execute without the patient's direct participation.

2. A licensed clinician — the form must be countersigned by an MD, DO, advanced practice nurse (APN), or physician assistant (PA). This clinician signature is what transforms the document from a preference statement into a medical order.

MOST vs. Living Will vs. Medical POA

These three documents serve different purposes, and families often confuse them:

Living Will (C.R.S. § 15-18-104) — a directive that applies only in terminal illness or persistent vegetative state. It tells doctors what treatments to withhold under those specific conditions. It does not cover day-to-day medical decisions.

Medical Durable Power of Attorney (C.R.S. § 15-14-506) — names a person (agent) to make healthcare decisions when the parent loses capacity. It grants decision-making authority but doesn't specify what decisions to make.

MOST form — contains specific, actionable orders for emergency and clinical teams. It applies in all medical settings and can be completed even after the parent has lost capacity (via the healthcare agent).

For comprehensive protection, an aging parent needs all three: the MDPOA to name a decision-maker, the living will to establish end-of-life preferences, and the MOST form to translate those preferences into standing medical orders.

How to Complete the MOST Form

Step 1. Schedule a goals-of-care conversation with your parent's primary physician. If the parent lacks capacity, the healthcare agent named in the MDPOA leads this conversation.

Step 2. Work through each section of the form together — CPR status, level of medical intervention, and nutrition preferences. The physician provides clinical context about what each option means practically for the parent's specific medical conditions.

Step 3. Both the patient (or surrogate) and the clinician sign the form.

Step 4. Print the completed form on green paper — specifically Astrobrights Vulcan Green or Terra Green 65-lb cardstock. This distinctive color ensures emergency responders can immediately locate and identify the form.

Step 5. Post the form in a visible location — typically on the refrigerator door or the back of the front door. Keep a copy in the parent's medical file and provide copies to all care facilities.

When to Update the MOST Form

The MOST form should be reviewed and potentially revised at every major care transition: hospital admission, discharge to a rehabilitation facility, transfer to assisted living or a nursing home, and any significant change in the parent's medical condition. The existing form remains valid until a new one is completed.

The CPR Directive Alternative

Colorado also offers a standalone CPR Directive under C.R.S. § 15-18.6-103, which specifically instructs emergency personnel to withhold resuscitation. This can be used independently or alongside the MOST form for situations where the only directive needed is a do-not-resuscitate order.

The Colorado Power of Attorney & Guardianship Kit includes step-by-step guidance on completing the MOST form alongside the medical POA and living will — so all three documents work together as a unified medical decision-making framework.

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