1. (a) The state department shall develop a standardized POST form and distribute the POST form.

2. (b) The POST form developed under this section must include the following:

   1. (1) A medical order specifying whether cardiopulmonary resuscitation (CPR) should be performed if the qualified person is in cardiopulmonary arrest.

   2. (2) A medical order concerning the level of medical intervention that should be provided to the qualified person, including the following:

      1. (A) Comfort measures.
      2. (B) Limited additional interventions.
      3. (C) Full intervention.
   3. (3) A medical order specifying whether antibiotics should be provided to the qualified person.
   4. (4) A medical order specifying whether artificially administered nutrition should be provided to the qualified person.

   5. (5) A signature line for the treating physician, including the following information:

      1. (A) The physician's printed name.
      2. (B) The physician's telephone number.
      3. (C) The physician's medical license number.

      4. (D) The date of the physician's signature.

         As used in this subdivision, "signature" includes an electronic or physician controlled stamp signature.

   6. (6) A signature line for the qualified person or representative, including the following information:

      1. (A) The qualified person's or representative's printed name.
      2. (B) The relationship of the representative signing the POST form to the qualified person covered by the POST form.
      3. (C) The date of the signature.
   7. (7) A section presenting the option to allow a declarant to appoint a representative (as defined in IC 16-36-1-2 ) under IC 16-36-1-7 to serve as the declarant's health care representative.
3. (c) The state department shall place the POST form on its Internet web site.
4. (d) The state department is not liable for any use or misuse of the POST form.

As added by P.L.164-2013, SEC.8. Amended by P.L.81-2015, SEC.13.