Missouri's Transportable Physician Orders for Patient Preferences (TPOPP) Form

A TPOPP form describes your wishes for health care in a medical emergency.

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You may have heard about a new kind of health care directive in Missouri, called a Transportable Physician Orders for Patient Preferences (TPOPP) form. Here, we discuss what a TPOPP form is and when you might need one.

What Is a TPOPP Form?

A TPOPP form is a doctor’s order that helps you keep control over medical care at the end of life. Like a Do Not Resuscitate (DNR) order, a TPOPP form tells emergency medical personnel and other health care providers whether or not to administer cardiopulmonary resuscitation (CPR) in the event of a medical emergency. A TPOPP form may be used in addition to -- or, sometimes, instead of -- a DNR order. The TPOPP form may also provide other information about your wishes for end-of-life health care, as explained below.

How to Make a TPOPP Form

In Missouri, TPOPPs are currently available at some large medical facilities in the Kansas City area. There are plans to make the form available statewide soon. A health care professional can help you create a TPOPP form if you enter a participating medical facility or health care setting. To be legally valid, the TPOPP form must be signed by a doctor. If a member of the medical staff does not ask you whether you want to create a TPOPP form, you may ask for one.

In Missouri, a TPOPP form is usually printed on bright pink paper so it will easily stand out in your medical records. The form travels with you if you move from one health care setting to another. You can change it or cancel it at any time.

How Does a TPOPP Form Differ From Other Health Care Directives?

A TPOPP form differs from a DNR order in one important way: A TPOPP form also includes directions about life-sustaining measures in addition to CPR, such as intubation, antibiotic use, and feeding tubes. The TPOPP form helps medical providers understand your wishes at a glance, but it is not a substitute for a properly prepared Living Will and Durable Power of Attorney for Health Care.

Taken together, a Living Will and Durable Power of Attorney for Health Care provide more information than a TPOPP form, including details about your health care agent, more complete health care wishes, and your preference for organ donation. Therefore, if you have a TPOPP form, you do not need a DNR order, but you should still complete additional health care directives to provide a full set of wishes about your care.

For details about preparing health care directives, see Missouri Living Wills and Durable Powers of Attorney for Health Care: What You Need to Know.

For More Information

To learn more about the Missouri TPOPP form, contact the Center for Practical Bioethics.

For general information about how to document your health care wishes, see the Living Wills & Medical Power of Attorney section of Nolo.com.

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