Form · Advance care · KS

Kansas advance directive form

The state's own form, from Kansas Office of Revisor of Statutes. Rivvi links it; we do not host or change it. Not legal advice.

Quick answer

Kansas's advance directive form is the 65-28,103 Declaration (living will statutory form), from Kansas Office of Revisor of Statutes. Kansas publishes a separate health care agent form: 58-632 Form of durable power of attorney (Durable Power of Attorney for Health Care Decisions). Open the state form

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The state form

Form: 65-28,103 Declaration (living will statutory form)
Publisher: Kansas Office of Revisor of Statutes
Law: K.S.A. 65-28,103
Form link: ksrevisor.gov/statutes/chapters/ch65/065_028_0103.html
Health care agent form: 58-632 Form of durable power of attorney (Durable Power of Attorney for Health Care Decisions)
Signing (per the source): Two or more witnesses at least 18, or acknowledged before a notary public (K.S.A. 65-28,103); POA: two witnesses of lawful age or notary acknowledgment
Link checked: October 23, 2026

Questions

Where do I get Kansas's advance directive form?

Kansas Office of Revisor of Statutes publishes it: 65-28,103 Declaration (living will statutory form). The link on this page goes to the state's copy (checked October 23, 2026).

Does Kansas have a medical power of attorney form?

Kansas publishes a separate health care agent form: 58-632 Form of durable power of attorney (Durable Power of Attorney for Health Care Decisions).

Does a Kansas advance directive need witnesses or a notary?

Per the state source: Two or more witnesses at least 18, or acknowledged before a notary public (K.S.A. 65-28,103); POA: two witnesses of lawful age or notary acknowledgment. Read the form's own signing instructions before you sign.