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Looking for Advance Directives forms?

All our Advance Directives forms can be found on our documents page, in addition to additional copies of forms available in Spanish and Vietnamese.

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Frequently Asked Questions:

The following information includes advance directive documents and information to understand the documents and their use.  These documents provide important information and help to assist individuals and families as they plan for the healthcare of their family members. Many of these documents must be signed in front of two people or a notary public.  WMREF provides free notary public services for these documents.  Please call for an appointment to use the notary public services. 316-686-7172. Forms must be signed in front of the notary public. 
 

If you have more questions regarding Kansas Advance Directives, please visit our FAQs page.

Summary of Advanced Directives:

Durable Power of Attorney for Health Care Decisions (DOPA-HC)

​ This form is sometimes called the Healthcare Power of Attorney. It is a signed and notarized or witnessed legal paper. It allows a person to name someone to make health care decisions for him/her during a time of disability or incapacity. (The person who has the power of attorney is called the health care agent, proxy, surrogate or DPOA-HC.)
 

  • The terms of the form may be fairly general or very specific, as desired. The powers granted usually include:

    • Decisions about going to the hospital​

    • Choice of doctors

    • Long term care​​​

  • The terms of this paper may include:

    • Refusing or withdrawing consent for the use of life sustaining procedures (even with the person is in a coma or persistent vegetative state.)​

    • Consent for organ donation and autopsy.

  • The person signing the DOPA-HC must be an adult (at least 18 years old) and competent when the document is signed. A person is usually assumed to be competent and does not need to prove it in the absence of actual notice of the opposite.

  • Witnesses must be at least 18 years of age. They cannot be the agent or related to the person be blood, marriage, or adoption. They cannot have a financial interest in the person's medical care or estate.

  • The HOPA may be effective only when the person lacks the capacity (as determined by a physician) to make or communicate decisions.

  • The healthcare agent may not cancel a person's Living Will.

Living Will

A Living Will is a signed and notarized or witnessed form that allows a person to state in advance that his/her dying should not be artificially prolonged in cases of terminal illness. This decision may be made only by the patient or by a person the patient has designated as Durable Power of Attorney for Healthcare. Relatives and even the patient's legal guardian do not have the authority to make this decision. The form is authorized by Kansas Law.

  • The person must be an adult (at least 18 years of age) and competent when the Living Will is signed.

  • Witnesses must be at least 18 years of age. They cannot be the agent or related to the person by blood, marriage, or adoption. They cannot have a financial interest in the person's medical care or estate.

  • The Living Will applies only when the person has been diagnosed and certified as terminally ill by two doctors. One of the doctors is the patient's attending physician. (Terminally ill usually means that death will probably occur within six months regardless of whether life-sustaining measures are used.)

  • The Living Will does not apply to a person in a coma or persistent vegetative state unless the person is also diagnosed as terminally ill.

Do Not Resuscitate (DNR) Directive

Patient's Do Not Resuscitate (DNR) Directive

A Patient's DNR Directive is a signed, dated, and witnessed form that lets an adult say in advance his/her decision that if his/her heart stops beating or breathing stops. No medical procedure will be done to restart the heart or breathing.

  • Other appropriate emergency medical care by pre-hospital care givers or medical care directed by a doctor may be given.

  • This form is authorized by Kansas Law.

  • The person must be an adult and competent when the paper is signed (at least 18 years old.) This document can only be signed by the patient/person and must be signed in front of the notary public.

  • The paper must also be signed by the attending physician as "medically appropriate" unless the person's church or religion recognizes treatment by spiritual means only.

Physician's Do Not Resuscitate (DNR) Order

A physician's DNR order (as distinguished from a patient's DNR Directive) may be any doctor's way of making a "do not resuscitate" order (sometimes referred to as "no code") in a medical care facility and adult care home, or an emergency medical service (if the method or order was established prior to April 14, 1994.)

  • It may be a separate paper or merely a physician's order in the patient's record.

  • Informed consent should be given by the patient or patient's healthcare agent.

Advance Medical Treatment Directive (Common Law)

An Advance Medical Treatment Directive (Common Law) can be any paper in which a person records his/her wishes regarding future medical treatment.
 

  • The form is not specifically authorized by Kansas Law.

  • It may be a checklist, a narrative statement, or a letter to the physician or person's healthcare agent.

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