Medical Order for Scope of Treatment (MOST)

Make a plan — and share your plan — to ensure you get the medical care you want and need.

New Mexico's MOST

The NM Medical Orders for Scope of Treatment is intended to complement or serve as an advance directive for those with serious illness or life limiting conditions. It is designed to make sure that seriously ill or very frail patients can choose the treatments they want or do not want. This approach ensures that their wishes are documented and honored.

In an emergency…

The NM MOST form is often printed on brightly colored green cardstock paper. Once complete, place it on the refrigerator, the back of the front door, or another prominent location so it can be easily found during an emergency.

How it Helps

The order is part of advance healthcare planning and is prepared by a medical professional. It encourages frank discussions between the patient and their healthcare provider and then identifies the specific kind of emergency care the patient wants or doesn’t want based upon the patient’s medical condition.

Tips for Completing the NM MOST

The NM MOST must be based on the patient’s current health status and should be completed during the course of a conversation between the patient and a healthcare professional.

  • Complete ID: Ensure patient demographics are completed to allow for proper identification.
  • Agreements: Ensure choices are clinically aligned.
  • Section A: Counsel patients on all options for resuscitation, including the ability to revoke a DNR at any time.
  • Section B: This section allows a patient to define the level of care that is consistent with their preferences. There is space provided for additional orders and clarifications of those orders.
  • Section C: If a patient elects a time-limited trial for hydration and/or nutrition, be sure to quantify and qualify the goal.
  • Physician signature: The NM MOST must be signed and dated by a physician (MD, DO), advanced practice nurse (APN), or physician assistant (PA).
  • Patient signature: The NM MOST must also be signed and dated by the patient or by their legally recognized healthcare decision maker (also known as a POA, durable medical power of attorney, or agent).
  • Retain the original: The original NM MOST form must stay with the patient. It is recommended that a copy of the form be placed in the patient’s medical record. Copies can be made and are valid.
MOST-cover
PDF For download. 2 pgs.

DOWNLOAD the NM MOST

To maintain consistency across all care facilities and communities in New Mexico, please follow these instructions:
  1. Download the New Mexico MOST form (link above).
  2. Copy or print onto Wausau Astrobright Terra Green 65 lb card stock.
Notes:
  • Wausau Astrobright Terra Green 65 lb card stock is available online and at some office supply stores.
  • Terra Green card stock is used to distinguish the form from other forms in the patient’s record and help First Responders to quickly locate the form in the patient’s residence. However, the form will be honored on any color paper.
  • Faxed copies and photocopies are also valid MOST forms.

RESOURCES:

Planning for your future healthcare is important to make sure you get the medical care you want if you become unable to speak for yourself. To do this, have a conversation with your doctor or healthcare provider. Make sure to talk about your health, possible outcomes, and treatment options. Then, ask your doctor or provider to complete the New Mexico Medical Orders for Scope of Treatment (MOST) form based on your choices made during that conversation. You and your doctor or provider need to sign and date the form. The NM MOST form is a legal document that goes into effect only if you become incapacitated and are unable to speak for yourself. It helps others know what type of medical care you want.