Free Kansas Medical Power of Attorney Form

Kansas calls this a durable power of attorney for health care decisions, governed by K.S.A. 58-625 to 58-632. It sits apart from a Kansas living will, which falls under the state’s Natural Death Act.

K.S.A. 58-629 covers what your agent can do and how you sign.

Two Disinterested Witnesses or a Notary

You can date and sign in front of two witnesses aged 18 or older. Alternatively, acknowledge the document before a notary public.

Both Witnesses Must Be Disinterested

Neither witness can be:

• Your agent
• Related to you by blood, marriage, or adoption
• Entitled to part of your estate under Kansas inheritance law or your will
• Directly financially responsible for your health care

Who Cannot Be Your Agent

Your treating health care provider and that provider’s employees cannot serve. Neither can an employee, owner, director, or officer of a facility caring for you. Relatives are the exception, along with members of the same religious community bound by vows.

When Authority Starts

Your agent’s powers take effect only once your attending physician determines you are impaired. The document can say otherwise if you want earlier authority.

No. Kansas law says an agent’s powers do not include revoking or invalidating a living will declaration you already made under the Natural Death Act.

That means both documents can work side by side. Your Kansas medical power of attorney names who decides, while your living will records choices your agent cannot undo. Your agent must also act consistently with the desires you have expressed.

Finish your Kansas medical power of attorney form with this sequence:

1. Use the statutory format, filling in your agent’s name, address, and phone number.
2. Mark any limits on your agent’s authority.
3. Choose whether authority starts immediately or on your incapacity.
4. Date and sign before two disinterested adult witnesses, or before a notary.
5. Confirm neither witness is related to you or would inherit from you.
6. Keep the original safe and share copies with your agent and doctors.

Kansas requires the document to be in substantially the statutory form in K.S.A. 58-632, titled “Durable Power of Attorney for Health Care Decisions.” That makes the structure part of what makes your Kansas medical power of attorney work.

Powers the Form Can Grant

Under K.S.A. 58-629, you can give your agent authority to:

• Consent to, refuse, or withdraw consent to care for a physical or mental condition
• Make arrangements at a hospital, psychiatric facility, hospice, or nursing home
• Hire or discharge doctors, nurses, therapists, and other health care personnel
• Request and review your medical records and sign releases to obtain them

Limits You Can Set

Your agent’s powers are limited to what the document states in writing. Kansas also allows treatment by spiritual means through prayer alone if that reflects your faith.