Advance Care Planning

Advance Care Planning

Deciding Now for Later

HHRC will help you make arrangements for lifelong healthcare, so that your time with family can be unburdened and your wishes will be respected now and later.

Durable Power of Attorney for Healthcare Decisions

You can use this form to name an individual, typically called a DPOA or Agent, who can legally make health care decisions for you during a time of disability or incapacity.

This form can give instruction to your designated agents on what treatment you would like and/or do not wish to receive during a medical crisis or for end-of-life care.

Declaration – Living Will

Use this form, commonly called a “Living Will,” to state in advance whether you want your life to be artificially prolonged in case of terminal illness. The Living Will gives your DPOA and physician(s) directions for your end-of-life wishes.

The Living Will applies only when a patient has been diagnosed and certified terminally ill by two physicians.

Healthcare Directive

On this form, you’ll state in advance what specific treatment options you would or would not want to receive. Use this form to help your DPOA understand your treatment preferences.

Do Not Resuscitate Order Request

This form allows you to elect to not receive Cardio-Pulmonary Resuscitation (CPR) used when you are in a terminal state in your disease process. This decision may be made by only you and your DPOA. In the state of Kansas, a physician’s signature is required.

This form states: “If my heart stops beating or if I stop breathing, no medical procedures to restart breathing or heart functioning will be instituted. No resuscitation will be attempted.” This form does not stop all treatment measures; it only stops resuscitation efforts.

Kansas Durable Power of Attorney

This document provides authority to another person to make financial decisions on your behalf.

A Durable Power of Attorney is a document that provides authority to another person to make financial decisions on your behalf. The person that you designate is generally referred to as the “Attorney in Fact” or as your agent. Please visit the Kansas Bar Association,, for further information about this document.

Medical Alert Information

First Responders can use this information to best care for you in times of critical emergencies. The Medical Alert Information will provide crucial information about your medical conditions, diseases, and medications.

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