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OTHER NAMES Kansas Living Will Kansas Advance Healthcare Directive Kansas Medical Directive Kansas Advance Medical Directive Kansas Advance Health Care Directive

What is a Kansas Advance Directive?

A Kansas Advance Directive (or "Declaration for Life-Sustaining Procedures") is a legal document that sets forth your preferences related to medical care, such as your request for or refusal of a certain medical treatment, and/or selection of a trusted healthcare agent. 
 
The person making an Advance Directive is called the "principal," while the person or entity obtaining permission to carry out the principal's wishes is known as the "agent." Designed for residents of Kansas, this free Advance Directive can be used in Sedgwick County, Shawnee County, Johnson County, and in all other parts of the state. Each Kansas Advance Directive from Rocket Lawyer can be modified to address your unique situation. As a result of this essential legal document, your healthcare providers will have a record of your decisions and your agent can provide proof that they have the authority to act in your interest when you are not able.

When to use a Kansas Advance Directive:

  • You're making sure your loved ones aren't put in the position of making important end-of-life healthcare decisions for you.
  • You're about to draft a complete estate plan, and want to make sure life-sustaining treatments are covered.

Sample Kansas Advance Directive

The terms in your document will update based on the information you provide

This document has been customized over 13.4K times
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LIVING WILL

and

HEALTH CARE POWER OF ATTORNEY

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

(LIVING WILL)

(HEALTH CARE PROXY)

(LIVING WILL AND HEALTH CARE PROXY)

DECLARATION

and

HEALTH CARE PROXY

LIVING WILL

and

MEDICAL DURABLE POWER OF ATTORNEY

DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE-SUPPORT SYSTEMS

HEALTH CARE INSTRUCTIONS

DOCUMENT CONCERNING THE APPOINTMENT OF A HEALTH CARE REPRESENTATIVE FOR HEALTH CARE DECISIONS

OF

DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

and

DESIGNATION OF HEALTH CARE SURROGATE

DECLARATION

and

STATUTORY FORM

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

A LIVING WILL

A Directive to Withhold or to Provide Treatment

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

LIVING WILL DECLARATION

and

COMBINED DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND HEALTH CARE REPRESENTATIVE APPOINTMENT

DECLARATION

and

DESIGNATION OF ADVOCATE FOR HEALTH CARE DECISIONS

HEALTH CARE POWER OF ATTORNEY

DECLARATION OF A DESIRE FOR A NATURAL DEATH

and

HEALTH CARE POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

ADVANCE HEALTH-CARE DIRECTIVE

INSTRUCTIONS FOR HEALTH CARE

and

HEALTH CARE POWER OF ATTORNEY

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION

HEALTH CARE PROXY OF

ADVANCE DIRECTIVE OF

LIVING WILL DECLARATION

and

HEALTH CARE POWER OF ATTORNEY

ADVANCE CARE PLAN

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

ADVANCE DIRECTIVE

and

MEDICAL POWER OF ATTORNEY

HEALTH CARE DIRECTIVE

and

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

DECLARATION TO PHYSICIANS

(WISCONSIN LIVING WILL)

and

HEALTH CARE POWER OF ATTORNEY

LIVING WILL

AND

MEDICAL POWER OF ATTORNEY

 

I. LIVING WILLI. ADVANCE DIRECTIVEI. DECLARATIONI. DOCUMENT CONCERNING WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMSI. A LIVING WILL - A DIRECTIVE TO WITHHOLD OR TO PROVIDE TREATMENTI. LIVING WILL DECLARATIONI. HEALTH CARE INSTRUCTIONSI. DECLARATION OF A DESIRE FOR A NATURAL DEATHI. HEALTH CARE DIRECTIVEI. DECLARATION TO PHYSICIANS (WISCONSIN LIVING WILL)Declaration made this ______ day of ____________________, _____. I, , willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare:This is an important legal document known as an advance directive. It is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values. In particular, you may want to consider what burdens or hardships of treatment you would be willing to accept for a particular amount of benefit obtained if you were seriously ill. You are encouraged to discuss your values and wishes with your family or chosen spokesperson, as well as your physician. Your physician, other health care providers, or medical institution may provide you with various resources to assist you in completing your advance directive. Brief definitions are listed below and may aid you in your discussions and advance planning. Initial the treatment choices that best reflect your personal preferences. Provide a copy of your directive to your physician, usual hospital, and family or spokesperson. Consider a periodic review of this document. By periodic review, you can best assure that the directive reflects your preferences. I, , being of sound mind, willfully and voluntarily make this Declaration for my care to be followed if I become unable to express my desires directly as a consequence of physical or mental incapacity or disability, regardless of whether this is caused by illness, accident, or other injury. This document is intended to direct all persons who are involved with my care including my relatives, physicians or personal representatives which I have appointed, or which hereafter may be appointed by the courts.
even if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be continued to prolong my life as long as possible within the limits of generally accepted health care standards.

__________ (initial) I have a terminal condition

__________ (initial) or I have an irreversible condition

__________ (initial) or I am in a persistent vegetative state

AND if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

 

TO RECEIVE artificially administered nutrition and hydration (food and fluids).NOT TO RECEIVE artificially administered nutrition and hydration (food and fluids) procedures, except as deemed necessary to provide me with comfort care.However, if at any point it is determined that it is not possible that the fetus could develop to the point of live birth with continued application of life-prolonging procedures, it is my preference that this document be given effect at that point. If life-prolonging procedures will be physically harmful or unreasonably painful to me in a manner that cannot be alleviated by medication, I request that my desire for personal physical comfort be given consideration in determining whether this document shall be effective if I am pregnant. I have discussed these decisions with my physician and have also completed a Physician Orders for Scope of Treatment (POST) from that contains directions that may be more specific than, but are compatible with, this Directive. I hereby approve of those orders and incorporate them herein as if fully set forth. I have not completed a Physician Orders for Scope of Treatment (POST) form. If a POST form is later signed by my physician, then this living will shall be deemed modified to be compatible with the terms of the POST form.

 

I designate , who may be reached at , as my Primary Physician.

 

 

 

 

 

 

 

 

including but NOT including . unless I initial the following line:

 

(YOU MUST DATE AND SIGN THIS LIVING WILL AND DESIGNATION

(YOU MUST DATE AND SIGN THIS DESIGNATION

IN THE PRESENCE OF TWO WITNESSES)

I affirm that this Living Will and Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

I affirm that this Designation is not being made as a condition of treatment or admission to a health care facility. I have read and understand the contents of this document and the effect of this grant of powers to my . I am emotionally and mentally competent to make this declaration.

 

I designate , who may be reached at , as my Primary Physician.

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this living will by . Further, at least one of us is not a spouse or blood relative of .

We, the undersigned witnesses, state that in the presence of each other and we have witnessed the signing of this Living Will and Designation by . I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

I have not been appointed as 's or Alternate . At least one witness is not 's spouse nor blood relative.

 

Date: ______________________________

 

Date: ______________________________

The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by , who is personally known to me or who has produced ________________________________ as identification.

Before me, a Notary Public (or justice of the peace) in and for said county, personally appeared the above named , ________________________________, and ________________________________, who acknowledged that they did sign the foregoing instrument, and that the same is their free act and deed. In testimony whereof, I have hereunto subscribed my name at ________________________________, this _____ day of ____________________, ______.

This instrument was acknowledged before me on this _____ day of ____________________, ______ by .

On this _____ day of ____________________, ______, before me personally appeared , to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed same as his/her free act and deed.

On this _____ day of ____________________, ______, before me, ________________________________, personally appeared , known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same as for the purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

 

_________________________________

My commission expires _____________

You should sign this document in the presence of a notary public. You should sign this document in the presence of two witnesses who then sign the document in your presence and in each other's presence. You should sign this document in the presence of a notary public and two witnesses who then sign the document in your presence and in each other's presence.

(your Agent)

You should discuss the document and your wishes with any person you want to designate as an Agent before doing so to assure they agree to act on your behalf.

 

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Kansas Advance Directive FAQs

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  • How do I write an Advance Directive in Kansas?

    It is fast and simple to document your medical preferences with a free Kansas Advance Directive template from Rocket Lawyer:

    1. Make the document - Provide a few simple details, and we will do the rest
    2. Send and share - Review the document with your healthcare agent or ask a legal question
    3. Sign it and make it legal - Required or not, witnesses/notarization are recommended

    This route, in many cases, will end up being notably less expensive than meeting and hiring your average law firm. If needed, you may prepare an Advance Directive on behalf of a relative, and then have them sign when ready. Please remember that for an Advance Directive to be legally valid, the principal must be mentally competent when they sign. If the principal has already been declared legally incompetent, a conservatorship might be required. When dealing with this scenario, it's best for you to work with a lawyer .

  • Why should I have an Advance Directive?

    Anyone who is over 18 ought to have an Advance Healthcare Directive (both a Healthcare Power of Attorney and a Living Will). Even though it can be difficult to think about, there will likely come a day when you are not able to make healthcare decisions on your own. Typical circumstances where it would be useful to make or update your Advance Directive include:

    • You will be undergoing a medical procedure that requires anesthesia
    • You are aging or dealing with ongoing health issues
    • You are managing a terminal condition
    • You currently live in or are planning to move into a community care facility

    Regardless of whether this Kansas Advance Directive has been made as a result of a change in your health or as part of a long-term plan, witnesses and/or notarization will often help to protect your document if its legitimacy is doubted.

  • Should I hire a lawyer to review my Advance Directive in Kansas?

    Making an Advance Directive is normally easy to do; however, you might need advice. Getting a lawyer to give feedback on your Kansas Advance Directive may be fairly time-intensive. A more cost-effective route is to go through the Rocket Lawyer attorney network. When you become a Premium member, you can get your documents reviewed or ask specific questions. You can rest assured that Rocket Lawyer will be here to support you.

  • On average, how much would I typically need to pay to make an Advance Directive in Kansas?

    The fees associated with finding and working with a conventional legal provider to draft an Advance Directive could add up to between $200 and $1,000. Rocket Lawyer can offer much more protection than many other Advance Directive template providers that you might come across. As a Rocket Lawyer Premium member, you can get up to 40% in savings when hiring an attorney from our network.

  • Will there be any next steps that I should be sure to take after drafting a Kansas Advance Directive?

    With a Premium membership, you will be able to edit it, save it in PDF format or as a Word file, and print it. When you are ready to wrap up your Advance Directive, it should be signed. You should make sure to provide a final copy of the signed document to your agent(s), care providers, and other impacted parties.

  • Does an Advance Directive need to be notarized or witnessed in Kansas?

    The specific requirements will vary in each state; however, in Kansas, your Advance Directive needs the signatures of two witnesses or a notary public. The witnesses to your document should not be anyone who is responsible for the cost of your healthcare, nor should they be family members (including your spouse or adopted children), heirs, or any other beneficiaries. As a basic principle, witnesses will need to be at least age 18, and none should simultaneously be acting as your agent.

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