Advance Healthcare Planning
Kansas Advance Directive

Kansas Advance Directive


Jennifer Mcgee


Updated on  

March 17, 2023

9 mins


When a person chooses to make a Living Will, along with the Medical Power of Attorney, these two legal documents become an Advance Directive. 

An Advance Directive may include your sign, names of witnesses, their signatures, etc. in adherence to your state’s requirements. Every state has different requirements to be followed. Some states ask for witnesses and notaries, others look for different criteria to be followed. 

Likewise, some states consider Living Will and Advance Directive as different and separate documents, whereas others consider both documents the same. In some states, Living Will and Advance Directive are used interchangeably. 

In this article, you will get a complete guide for making an Advance Directive for Healthcare in Kansas.  

Legal Requirements for a valid Advance Directive

  • Written by the grantor (maker of Advance Directive): Yes
  • Grantor must be:
  • Above the age of 18 years: Yes
  • Sound mind and memory: Yes
  • Signed by the grantor: Yes/direct anyone else to sign on his behalf
  • Signed by Proxy/Agent: No
  • Proxy/agent accepts his role in writing: No
  • Witness required: Yes
  • Number of witnesses: 2
  • Signed by the witnesses: Yes
  • Number of documents required: 2 (Advance Directive Form + Organ Donation Form)
  • Other names for a Living Will in Kansas: Declaration
  • Other names for a Healthcare Power of attorney in Kansas : Durable Power of attorney for healthcare
  • Proxy can decide on mental health issues: No
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Who can be your witnesses in the Kansas Advance Directive?

Anyone can be your witness in Kansas if;

  • He is an adult i.e., above 18 years of age, and
  • He is a sound-minded person which means that he can understand the consequences of making an Advance Directive and the laws applied to it.

Note: Your witnesses cannot be: 

  • Your healthcare proxy/agent,
  • Your supervising health care provider/ his employer,
  • Related to you by blood, adoption, or marriage
  • The person signing your form for you, 
  • A person entitled to any portion of your estate,
  •  A person directly financially responsible for your health care.
Advance Directive Kansas

Who can be your Proxy in the Kansas Advance Directive?

Anyone can be your Proxy/Agent in Kansas if;

  • He is an adult i.e., above 18 years of age, and
  • He is a sound-minded person which means that he can understand the consequences of making an Advance Directive and the laws applied to it.

Who cannot be your Proxy/Agent:

  • your supervising health care provider, 
  •  if you are receiving care  at a health care institution then its employee.
  • an employee of any hospital, psychiatric hospital or psychiatric treatment facility, hospice, nursing home, or similar institution.


  • Your agent related to you by blood, marriage, or adoption or is a co-member of a religious order to which you belong 

That means your agent must be more distantly related to you by blood or adoption than your uncles, aunts, nephews, nieces, great-grandparents, and great-grandchildren or by marriage than your step uncles, step aunts, step nephews, step nieces, step great grandparents, and step great-grandchildren.

Other than the above legal requirements, the Proxy/Agent should be:

  • Trustable to adhere to your wishes and intentions.
  • Trustable to defend you if there’s any disagreement about your medical care.
  • He wanted to be your Attorney in Fact of his own free will to take care of your health affairs.
  • He should not be your doctor or one of the caretakers.

Note: You can appoint an Alternate Proxy as well. The alternative Proxy/Agent will step in if the first person you name as a proxy is unable, unwilling, or unavailable to act for you or if you decide to revoke his authority.

Notarization required for Kansas Advance Directive?

You can either get an Advance Directive executed by signing the form in presence of the witnesses or get your signature notarized by signing an acknowledgment in front of the public notary.

Learn about the requirements of Kansas Last Will and Testament and Kansas Last Will and Testament Template.

When does an Advance Directive come into effect in Kansas?

In Kansas, an Advance Directive becomes legally valid but doesn’t come into effect on signing the form by the grantor, proxy, and witnesses. 

An Advance directive comes into effect only when the doctor declares that you are incapable of deciding on your own and have become debilitated due to illness or injury.

Note: Your Kansas Advance Directive will not be effective in any medical crisis or emergency unless you become incapacitated to understand and communicate your wishes and consent.

How can an Advance Directive be revoked?

You can revoke or terminate your Kansas Advance Directive anytime in any way either by:

  • A written revocation,
  • An oral revocation in presence of a witness who is of 18 years of age or above, and

(That witness must sign and date a written confirmation that you made an oral revocation. An oral revocation becomes effective when your doctor or health care provider receives a copy of this document.) 

  • Tearing, burning, and obliterating or destroying the document in any other way or directing anyone to destroy it in your presence,
  • Executing a new Advance Directive or directing another person to execute.

Note: Your revocation becomes effective when you communicate this revocation to your attending physician. 

How to amend or change an Advance Directive? 

You can make changes or amend your Advance Directive at any time in Kansas but once you have signed and witnessed/notarized it you have to remake a new document with the required changes. It is recommended to go through, double-check, and make sure of everything before signing the Advance Directive.

Kansas rules for pregnancy after making your Advance Directive

A pregnant patient’s Kansas Declaration will not be honored if it is possible that the fetus could develop to the point of live birth with continued application of life-sustaining treatment.

Document 1: Declaration (Living Will) + Durable Power of Attorney= Advance Directive

Parts of the Kansas Advance Directive Form

Part 1: Durable Power of attorney for health care

You can fill this form out and provide all the details. The appointment of the Healthcare Proxy/Agent and his details will be filled along with the instructions for the Proxy/Agent to follow.

Kansas Advance Directive Sample Form


GRANT OF AUTHORITY TO AGENT I , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , 

(name) designate and appoint: _ 

(name of agent) (address) (home telephone number) (work telephone number) or,

 in the event the person I appoint above is unable, unwilling or unavailable to serve, I appoint: 

(name of alternate agent) (address) (home telephone number) (work telephone number) to be my agent for health care decisions and pursuant to the language stated below, on my behalf to: 

(1) Consent, refuse consent, or withdraw consent to any care, treatment, service, or procedure to maintain, diagnose, or treat a


Part 2: Declaration

This section states your wishes regarding medical care when your doctor determines that either 

  • that you are terminally ill and to prolong artificially your life you would need artificial life-sustaining procedures or your death will occur with or without the use of life-sustaining procedures, or 
  • that you are in a persistent vegetative state.

Kansas Advance Directive Sample Form


Declaration made this day of , 

(day) (month) (year) I, , (name) 

being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, and do hereby declare: 

If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two physicians who have personally examined me, one of whom shall be my attending physician, and the physicians have determined that my death will occur whether or not life-sustaining procedures are utilized, and where the application of life-sustaining procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn, 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.


Part 3: Execution

Kansas Advance Directive Sample Form


I understand the full importance of this document and I am emotionally and mentally competent to appoint an agent and/or make this declaration. Signed Date City, County and State of Residence 

Alternative No. 1, Witnesses: 

The declarant has been personally known to me and I believe him or her to be of sound mind. I did not sign the declarant’s signature above for or at the direction of the declarant. I am not appointed above as the declarant’s agent. I am not related to the declarant by blood or marriage, entitled to any portion of the estate of the declarant according to the laws of intestate succession or under any will of declarant or codicil thereto, or directly financially responsible for the declarant’s medical care. 





Alternative No. 2: Acknowledgement by Notary Public: 


County of ) 

This instrument was acknowledged before me on 

(date) by  (name of principal) 

(Seal, if any) 

My appointment expires:

Document 2: Donation of organs form

Kansas Advance Directive Sample Form


[   ] I do not want to make an organ or tissue donation and I do not want my attorney for health care, proxy, or other agent or family to do so. 

[   ] I have already signed a written agreement or donor card regarding organ and tissue donation with the following individual or institution: 

Name of individual/institution: 

[    ]  Pursuant to Iowa law, I hereby give, effective on my death: 

Any needed organ or parts. The following part or organs listed below: 

For (initial one): 

[   ] Any legally authorized purpose. 

[   ] Transplant or therapeutic purposes only. 

Declarant name: 

Declarant signature: ______ Date: 

The declarant voluntarily signed or directed another person to sign this writing in my presence. 

Witness Date Address

I am a disinterested party with regard to the declarant and his or her donation and estate. 

The declarant voluntarily signed or directed another person to sign this writing in my presence. 


Date_ Address________

Give photocopies of the signed original to your agent and alternate agent, doctor(s), family, close friends, clergy, and anyone else who might become involved in your health care. If you enter a nursing home or hospital, have photocopies of your document placed in your medical records. 

Be sure to talk to your agent(s), doctor(s), clergy, family, and friends about your wishes concerning medical treatment. Discuss your wishes with them often, particularly if your medical condition changes.

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Frequently Asked Questions

How do I get a DNR in Kansas?

The patient's physician must endorse the decision and sign the form to make DNR form legally valid. However, in cases where the patient is a member of a church that provides treatment by spiritual means, a physician's signature is not required. The patient, physician, and witnesses are required to sign.

How do I write a living will in Kansas?

In Kansas, your living will must be a written document dated, and signed by you, or signed by someone else for you in your presence and at your direction. Two or more witnesses are required, and they must be at least 18 years of age.

What are the 2 major challenges with advance directives?

Advance directives have limitations. For example, an older adult may not fully understand treatment options or recognize the consequences of certain choices in the future. Sometimes, people change their minds after expressing advance directives and forget to inform others.

What is the difference between advance care planning and an advance directive?

The Advance Directive is a formalized version of your Advance Care Plan. An Advance Directive is a document through which you plan your healthcare and your preferences for your future care.

Is a handwritten will valid in Kansas?

A holographic will that is wholly handwritten by the testator isn’t valid in Kansas. A valid will in Kansas must be written and signed by the person who is making the will (testator) or by someone else in the presence of and at the express direction of the testator. Signed by two or more competent witnesses in whose presence the testator signed the will.
Jennifer Mcgee
Parent to five young children. Estate Planning, Probate, and Family Law Attorney. Volunteer with Victim’s Advocates in the local sheriff's department...
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Jennifer Mcgree
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