US-KS · Customized Agreements · State-informed
Kansas Living Will / Health Care Declaration
Locke uses the official-form living-will route for Kansas: Declaration. Combined-form agent, proxy, or donation sections stay VOID in this product. This document records treatment wishes only. It does not appoint a healthcare agent and is not Kansas TPOPP / DNR medical order.
State-informed coverageKansas selectedCounty nextAddress when relevant
Pinned Kansas record · not a catalog claim
What this Kansas instrument is
| Topic | Maintained record |
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| Instrument | Declaration |
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| Route | Official or statutory form, treatment part only |
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| Healthcare agent | Not appointed by this document. Use the separate Advance Healthcare Directive and Medical Power of Attorney. |
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| Medical order | In Kansas, do not represent this Living Will as the separate clinician/EMS medical-order instrument identified here. Separate instrument: Kansas TPOPP / DNR medical order. |
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| Execution | Use the declaration substantially in the form required by K.S.A. 65-28,103, signed and dated with either two qualified witnesses or a notary acknowledgment. |
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| Pregnancy rule | Current law materially limits or suspends treatment instructions during pregnancy. The state pack must disclose the restriction and may not offer a choice that law does not permit. |
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| Authority | K.S.A. 65-28,103 (checked 2026-08-20) |
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Visible coverage maturity · State-informed
What this coverage level means
| Coverage area | Status | What that means |
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| Product availability | Available | Living Will / Health Care Declaration is released for purchase and can begin with Kansas selected. |
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| Coverage maturity | State-informed | This document resolves maintained state-family configuration blocks. That is not a claim that every action-specific state or local rule has been reviewed. |
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| State configuration | Maintained | living-will-health-care-declaration:healthcare_directive__KS, version 2.2.0, Healthcare Directive. |
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| County and address | Collected when relevant | These facts narrow the document context but do not prove that every local rule has been identified. |
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| Attorney review | Customer-arranged | Legal advice is not included; counsel of the customer's choice may review the completed document. |
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What Locke collects
Information that shapes this document
- State, county, and address from the jurisdiction-first workflow
- Legal name, current address, and signing date
- Treatment elections required by the selected state's directive model
- Optional values/additional instructions where the selected form allows them
- Whether separate agent or clinician-order documents already exist
What this document covers
Built for the stated scope
- Advance treatment planning before illness or injury
- Standalone treatment instructions without appointing a healthcare agent
- Coordinating written treatment wishes with an existing healthcare proxy
- Recording pregnancy-related and execution rules that vary by state
Configuration record · living-will-health-care-declaration:healthcare_directive__KS · 2.2.0
How the Kansas lane enters this draft
Locke selects this document family’s maintained state configuration after the state answer is saved. County, address, and later interview answers narrow any clauses that use those facts.
Declaration
KANSAS DECLARATION Declaration made on the information supplied in the interview. I, the information supplied in the interview, being of sound mind, voluntarily make known my desire that my dying not be artificially prolonged under the conditions stated below. If I have an incurable injury, disease, or illness certified as a terminal condition by two physicians who have personally examined me, one of whom is my attending physician, and death will occur whether or not life-sustaining procedures are used, I direct that procedures serving only to artificially prolong dying be withheld or withdrawn. Medication and medical procedures necessary for comfort care remain authorized. If I cannot give directions, I intend this Declaration to be honored as the final expression of my right to refuse medical or surgical treatment and to accept the consequences of that refusal. Additional specific directions: the information supplied in the interview I understand the significance of this Declaration and make it voluntarily. Signature: Date: the information supplied in the interview City, County and State of Residence: the information supplied in the interview Complete either the witness route or the notary route Witness 1: Witness 2: The witnesses must satisfy K.S.A. 65-28,103 qualifications. OR State of County of Acknowledged before me by the information supplied in the interview. Notary Public: My appointment expires: Under current Kansas law, the declaration has no effect during the pregnancy of a qualified patient diagnosed as pregnant by the attending physician. This document does not create a DNR or TPOPP medical order.
Separate Medical Order — Kansas
In Kansas, do not represent this Living Will as the separate clinician/EMS medical-order instrument identified here. Separate medical-order instrument: Kansas TPOPP / DNR medical order. This Living Will is not represented as that clinician/EMS medical order.
Locke is a document-assistance platform, not a law firm, and does not provide legal advice. Outputs require professional review; consult counsel of your choice.
Known coverage limit
County, municipal, court, and agency rules may still apply
Requirements may also depend on a Kansas county, municipality, city ordinance, rent board, local court, recorder, clerk, licensing authority, zoning district, property location, or another local body. Collecting a county and address does not mean Locke has identified every applicable local rule.
Before purchase
Questions about this state-configured document
Does a Kansas living will appoint a healthcare agent?
No. This Locke Direct product is treatment-wishes only. Agent appointment is a separate product.
Is the Kansas living will a Kansas TPOPP / DNR medical order?
In Kansas, do not represent this Living Will as the separate clinician/EMS medical-order instrument identified here.
How do I sign a Kansas living will?
Use the declaration substantially in the form required by K.S.A. 65-28,103, signed and dated with either two qualified witnesses or a notary acknowledgment.
How is the Living Will / Health Care Declaration configured for Kansas?
After you select Kansas, Locke asks for the county and address, when relevant, and applies the maintained Kansas configuration for this document family to your answers.
Is this a guarantee that the Living Will / Health Care Declaration will be valid?
No. Locke assists with document generation and does not guarantee legal validity, enforceability, filing acceptance, or a particular outcome.
When is payment enabled?
You can preview first. Checkout is not enabled until you affirm the required acknowledgment that Locke Direct is not a law firm and does not provide legal advice.