Kansas Living Will Form

The Kansas living will is a legal document that shall allow an individual (Principal) to outline in advance and while they are of sound mind, their final wishes with regard to their medical care should the Principal find that they are no longer able to communicate their wishes on their own due to any sort of illness, injury or disease. In the state of Kansas, this document is considered a legal statement from the individual and no health care representative is necessary unless stated by the Principal. This document will, however, require the signatures of two witnesses or must be notarized.

Laws – Kansas Statutes Chapter 65: , Article 28: , Sections 101-109: Natural Death Act

How to Write

Step 1 – Download and date the declaration document in dd/m/yy format

  • Submit the name of the Principal
  • Date of birth in mm/dd/yyyy format
  • City of residence
  • County of residence
  • State
  • The Principal must read and agree to the remainder of the paragraph as well as the following two paragraphs
  • The Principal must then read the competency statement
  • Select whether or not the Principal would like to provide additional instruction and check the applicable box. If additional instructions will be provided, enter them on the back side of the document
  • Submit the Principal’s signature

Step 2 – Witness Signatures OR Notarization – If the Principal elects to have witnesses sign the document, they may not be related to the Principal:

  • Witnesses Signatures (respective)
  • Witnesses addresses
  • OR
  • The notary may witness the Principal’s signature and acknowledge the document by completing the notary information and affixing the notary seal

Step 3 – Optional Instructions – These instructions are optional and completely up to the Principal. If the Principal would like to consider using these instructions they may follow the instructions and choose, again, two witnesses to sign the document after completion or have the optional instructions notarized once completed