Molst Forms
Use a Molst Form template to make your document workflow more streamlined.
What MOLST Forms are used for
MOLST Forms record a patient’s preferences for life-sustaining treatment in a clinician-guided healthcare workflow. The form is completed for an identified patient, reviewed with the appropriate participants, and signed according to applicable state requirements. With signNow, an organization can upload its approved MOLST template, detect or place fillable fields, assign signer roles, send the document electronically, and retain the completed file with an audit trail. State law, the issuing healthcare authority, and facility policy determine whether electronic completion is permitted and which signatures or witnessing steps are required.
Who uses MOLST Forms and why
Healthcare providers
Clinicians use MOLST Forms to document treatment preferences and obtain required signatures from patients or authorized representatives. The workflow should preserve the completed record, identify each signer, and follow the healthcare organization’s privacy, access, and retention policies.
Hospice and care teams
Hospice and long-term-care teams coordinate MOLST completion among attending clinicians, residents, families, and legal representatives. SignNow can route the document electronically, while staff remain responsible for confirming clinical authority and state-specific form requirements.
Manage MOLST users and permissions
A hospital records administrator can publish one approved MOLST template, limit editing rights, and monitor completed documents through shared folders and audit trails. Delegated sending lets authorized clinical staff initiate a patient-specific packet without changing the controlled template or bypassing organizational permissions. A hospice operations team can assign signing roles for clinicians, patients, and representatives, then use account controls to separate template ownership from day-to-day sending. signNow’s reusable templates and delegated workflows reduce duplicate entry while keeping responsibility for each signing action visible.
Features that support MOLST completion
A controlled signNow workflow can organize the specific people, fields, signatures, and records involved in completing a MOLST document.
Template preparation
Upload the approved MOLST PDF, detect existing fields, and add patient, clinician, representative, date, and signature fields without rebuilding the document from scratch.
Role-based routing
Assign each MOLST participant a defined signing role so clinical staff can route the document in the intended sequence and identify incomplete actions.
Audit trail
Capture signer actions, timestamps, and delivery events in a signNow audit trail that can accompany the completed MOLST record during archival.
Remote signing
Use email delivery, mobile apps, or controlled signing links to coordinate patient and clinician review when participants are not in the same location.
Signer verification
Apply SMS or other configured authentication steps when the organization requires stronger evidence that the intended participant accessed the MOLST document.
Connected records
Connect approved workflows with platforms such as Microsoft 365, Google Drive, Box, or healthcare systems through supported integration and storage processes.
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How to complete a MOLST in signNow
Prepare the approved state or facility template first, then use signNow to route the patient-specific MOLST and preserve completion evidence.
Upload form:
Upload the approved MOLST PDF to signNow. Map fields:
Review detected fields and add missing fields. Assign roles:
Assign patient, clinician, and representative roles. Send document:
Send the MOLST through the approved channel. Archive record:
Review signatures and export the record.
What the MOLST audit trail records
The audit trail documents signing activity separately from template setup, helping records staff connect the completed MOLST with evidence of its execution.
Authenticate signer:
Capture timestamps:
Hash document:
Seal document:
Log actions:
Export audit trail:
Platform requirements for MOLST workflows
SignNow MOLST workflows run in current Chrome, Firefox, Safari, or Edge browsers on Windows and macOS. Staff can also use signNow mobile applications on iOS and Android to review, send, or sign assigned documents. Use an organization-managed device when patient information is involved.
Browsers Chrome, Firefox, Safari, Edge Desktop systems Windows and macOS desktops Mobile apps iOS and Android applications
Healthcare organizations should configure managed devices, role-based access, and approved storage before sending MOLST documents. Enterprise teams may also evaluate API access, SSO provisioning, and certificate configuration against their privacy program. Browser access alone does not determine whether a state permits electronic MOLST execution or which clinical signatures are required.
Signer authentication for MOLST Forms
Signer authentication:
Two-factor authentication:
ID verification:
PKI signatures:
X.509 certificates:
Audit evidence:
Record-keeping practices for MOLST Forms
A MOLST record needs controlled handling from signature through archival because it contains sensitive health information and treatment preferences.
Set retention from applicable authority
Preserve the audit trail with the record
Archive records with restricted access
Verify every required field before filing
Legal standing and exclusions
Electronic MOLST signatures may be recognized under ESIGN and applicable state electronic-transactions law when intent, consent, signer attribution, and record reproducibility are established. Those laws do not override state healthcare-form rules, and ESIGN excludes wills, court orders, and certain family-law documents. Confirm the governing state’s MOLST requirements before relying on electronic execution.
Privacy and disclosure pitfalls
Sending a MOLST to an unintended recipient can expose treatment preferences and other protected health information outside the approved care team. A missing consumer electronic-record disclosure may weaken the evidence that a patient consented to receive and sign the MOLST electronically. Overly broad folder permissions can let staff view, download, or alter sensitive MOLST records without a documented care or records-management need. Treating a completed signature as sufficient without checking clinician authority, representative status, and state execution rules can leave the MOLST operationally incomplete.
Healthcare MOLST workflow examples
Healthcare organizations can adapt signNow workflows to coordinate MOLST documents while preserving role clarity and signed-record visibility.
Healthcare operations
Fertility Centers of Illinois needed responsive digital workflows for patient-facing documents and signatures across its healthcare operations.
- Patient forms for distributed care teams
- Secure signing across desktop and mobile devices
Fertility Centers of Illinois selected airSlate SignNow for its responsive team and API capabilities. For a MOLST workflow, a healthcare organization can use the same controlled process to route patient-care documents, capture signatures, and maintain a retrievable completion record.
Hospital care team
A regional hospital can use a MOLST template to coordinate signatures among clinicians, patients, and authorized representatives without repeatedly rekeying patient information.
- Role-based routing for clinical approvals
- Audit trail for completed records
The hospital’s administrator can restrict template editing, assign signing roles, and send the completed MOLST document to approved recipients. The resulting audit trail records signing activity, while the organization’s retention policy determines how long the record remains available.
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MOLST Forms troubleshooting and FAQ
These answers address field mapping, signer identity, protected health information, electronic consent, and record retention for MOLST workflows.
Upload the organization’s approved MOLST PDF again, then use signNow’s field detection or place fields manually. Confirm that patient identifiers, treatment selections, clinician fields, representative details, dates, and signature fields map to the correct locations before sending.
A signNow Business plan includes legally binding eSignatures, templates, audit trails, and mobile apps. Business Premium adds bulk send and kiosk mode, but a plan feature does not replace state-required clinical review, witnessing, notarization, or paper procedures.
For patient-facing electronic records, ESIGN requires consumer disclosure and access procedures under 15 U.S.C. §7001(c). Give the patient the required disclosure, confirm electronic access, and provide withdrawal procedures before requesting an electronic signature.
Use assigned roles and signer authentication to distinguish the clinician, patient, and authorized representative. The signNow audit trail records signing events, but the healthcare organization must verify authority, identity, and the state-specific MOLST execution requirements.
SignNow states that HIPAA compliance requires a BAA. Confirm that the organization’s plan and agreement support the intended protected-health-information workflow, then apply access controls and retention rules required by HIPAA and facility policy.
Export the signed MOLST and audit trail after completion, then store them in the approved clinical-record repository. HIPAA requires certain policies and procedures to be retained for six years under 45 CFR §164.530(j), while state clinical-record rules may require longer.
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