@susanejw Here is a link for the Maryland version of what I have:
https://marylandmolst.org/docs/MOLST%20MM3%202013%20FINAL%20PROPOSED%2072613%20POSTED%2021714.pdf
Please read it carefully, and discuss it with a medical professional. It will need to be signed by one, anyways! For my POLST, I have a refrigerator magnet that gives my state registration number.

Let me know if I can be of further help?
Ginger