Advance Directive for Health Care Form - Kansas

Advance Directive for Health Care Form - Kansas

A Kansas Advance Directive for Health Care is a set of instructions about preferred medical care that takes effect when a patient becomes unable to make decisions. In addition to listing preferences for medical care, the form provides individuals with the option of appointing a health care proxy. A health care proxy - otherwise known as a health care agent or surrogate - is a person who has the authority to make health-related decisions on another person's behalf.

Download a pre-made form through the link below or make your own Advance Directive with our form builder.

If an individual has never had an Advance Directive made, any health care decisions may be made for them by a court-appointed guardian (a spouse, an adult child, an adult sibling, an adult relative or a professional).

There is a difference between this form and a Living Will in Kansas. A Living Will is a specific type of an Advance Directive for Health Care that becomes effective only in the event of a terminal illness. The form is regulated by § 65-28,101 of K.S.A. Chapter 65 . The document must be witnessed by two (2) or more adult individuals.

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What Is a Kansas Advance Directive?

An Advance Directive is a written form that lists an individual's preferences for medical care and grants a spouse, child, family member, friend or attorney the authority to make decisions regarding health care on the individual's behalf. All of these documents include two separate parts:

  1. A Medical Power of Attorney - also known as a Health Care Power of Attorney - in which the individual elects a person to make medical decisions when they are unable to do so due to being terminally ill, seriously injured, in a coma or near the end of life.
  2. A Living Will - a written, legal document that lists an individual's wishes regarding life­-sustaining procedures, pain management or organ donation that takes effect when the patient is terminally ill.

How to Write an Advance Directive in Kansas?

You'll need to follow these important steps when preparing your document:

STEP 1 - Choose your health care agent - or proxy. This agent should be a person you trust to make medical decisions for you.

STEP 2 - Consider the kinds of treatment you do or do not want to receive in the event of a serious illness or incapacitation. Consider whether you want to:

  • Take antibiotics to treat infections;
  • Receive cardiopulmonary resuscitation (CPR);
  • Be on an extracorporeal membrane oxygenation (ECMO) machine when you cannot breathe on your own;
  • Be on a dialysis machine in case of kidney failure;
  • Be tube-fed if you can't eat or drink on your own.

STEP 3 - Keep the original completed and signed Advance Directive form with your medical records and give copies out to your health care proxy, physicians, health care providers, and - if necessary - to family members and close friends.

Download Advance Directive for Health Care Form - Kansas

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