The Kansas Living Will is the formal way to make family members and physicians aware of what you would like to materialize when confronted with end-of-life circumstances. Basically, the form is furnished with a general statement that expresses that the declarant wishes not to receive any life-prolonging procedures when it has been determined that their condition is uncurable/irreversible. To properly implement this legal instrument, the declarant must simply insert their name, date & sign it, and have their endorsement acknowledged by two (2) witnesses or a notarial officer.
Individuals seeking to donate their organs/tissues to someone in need should register within the state’s online database by visiting the Donate Life Kansas Website.
Laws
Statutes – § 65-28,101 – § 65-28,109
Definition – “Declaration” means a witnessed document in writing, voluntarily executed by the declarant in accordance with the requirements of K.S.A. 65-28,103 (§ 65-28,102(b)).
Statutory Form – § 65-28,103(c)
Signing Requirements – Must be signed by the declarant and receive the acknowledgment of two (2) witnesses (§ 65-28,103(a)(4)(A)) or a notary public (§ 65-28,103(a)(4)(B)).
Revocation – § 65-28,104
Other Versions (3)
Download: Adobe PDF
Download: Adobe PDF
Wichita Medical Research & Education Foundation (WMREF) Version
Download: Adobe PDF
Additional Resources
- Donate Life Kansas – Organ, Eye, and Tissue Donor Registry Information
- Kansas Bar Association – Living Will Information
- Kansas Legal Services – Advance Directives Handout
- Kansas State University – Advance Health Care Planning
- Kansas State University – Do Not Resuscitate Directives
- LMH Health – Advance Directives Guide
- United Healthcare – Advance Directives Handout
- WMREF – Kansas Advance Directives FAQ
- WMREF – Kansas Advance Directives Pamphlet
- WMREF – Life-Sustaining Treatments (also available in Spanish/en Español)
- WMREF – Make the Decision Yours
- WMREF – Medically Assisted Nutrition and Hydration
- WMREF – Understanding Do-Not-Resuscitate (also available in Spanish/en Español)
Related Forms (7)
- Advance Directive (Medical POA & Living Will)
- Advance Directive Wallet Cards
- Do-Not-Resuscitate (DNR) Directive
- Durable (Financial) Power of Attorney
- HIPAA Privacy Authorization Form
- Organ Donation Form
- Transportable Physician Orders for Patient Preferences (TPOPP) Form
Advance Directive (Medical POA & Living Will)
Download: Adobe PDF
Advance Directive Wallet Cards
Download: Adobe PDF
Do-Not-Resuscitate (DNR) Directive
Download: Adobe PDF (also available in Spanish/en Español)
Laws: § 65-4941 – § 65-4948
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
HIPAA Privacy Authorization Form
Download: Adobe PDF
Download: Adobe PDF
Transportable Physician Orders for Patient Preferences (TPOPP) Form
Download: Adobe PDF