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Kansas Advance
Health Care Directive
This form lets you have a say about how you
want to be cared for if you cannot speak for yourself. This form has 3 parts:
Part 1 Choose a medical decision maker,
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How to fill out health care directives

How to fill out health care directives
01
Begin by obtaining the necessary forms for health care directives. These forms are typically available online or from your local hospital or healthcare provider.
02
Familiarize yourself with the different sections of the form, including the personal information section, the appointment of a healthcare agent section, and the specific healthcare instructions section.
03
Start by entering your personal information, including your full name, date of birth, and contact information.
04
Select a trusted individual to serve as your healthcare agent. This person will be responsible for making healthcare decisions on your behalf if you are unable to do so. Provide their name, contact information, and any alternate agents you wish to appoint.
05
In the specific healthcare instructions section, outline your preferences regarding medical treatment, end-of-life care, and other relevant instructions. Be as clear and detailed as possible to ensure your wishes are fully understood.
06
Consider discussing your healthcare directives with your healthcare agent, family members, and healthcare providers to ensure they understand your wishes and are willing to honor them.
07
Once you have completed the form, review it carefully to make sure all information is accurate. Consider seeking legal advice or guidance if you have any concerns or questions.
08
Sign and date the form in the presence of witnesses or a notary public, as required by your state's laws.
09
Keep a copy of the completed form for yourself, and distribute copies to your healthcare agent, primary physician, and any other relevant individuals or organizations.
10
Periodically review and update your health care directives as needed, especially if there are significant changes in your medical condition or personal circumstances.
Who needs health care directives?
01
Everyone, regardless of age or health condition, can benefit from having health care directives.
02
Individuals who have specific preferences or wishes regarding their medical treatment and end-of-life care.
03
Those who want to ensure their healthcare wishes are respected and followed if they become unable to make decisions themselves.
04
People with chronic illnesses, life-threatening conditions, or significant medical conditions.
05
Elderly individuals who may be at higher risk of medical emergencies or incapacity.
06
It is recommended to consult with a legal professional or healthcare provider to determine the specific requirements or recommendations for health care directives in your jurisdiction.
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What is health care directives?
Health care directives are legal documents that outline an individual's preferences and instructions for medical treatment in the event they are unable to communicate their wishes.
Who is required to file health care directives?
Any individual over the age of 18 is encouraged to create and file health care directives, but it is not mandatory.
How to fill out health care directives?
Health care directives can be filled out with the assistance of an attorney, online templates, or through healthcare providers. It is important to ensure that the document is signed and witnessed.
What is the purpose of health care directives?
The purpose of health care directives is to allow individuals to have control over their medical treatment and to ensure their wishes are followed if they are unable to communicate.
What information must be reported on health care directives?
Health care directives typically include information on the individual's chosen healthcare agent, treatment preferences, resuscitation wishes, and organ donation decisions.
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