Fill out VA 10-0137 (VA Advance Directive) online
VA Form 10-0137 is the VA Advance Directive, combining a Living Will and Durable Power of Attorney for Health Care into a single document. It allows veterans to document their healthcare wishes in advance, designate a healthcare agent to make medical decisions on their behalf, and specify their preferences for end-of-life care.
How to fill out VA 10-0137 (VA Advance Directive)
Designate your healthcare agent
Name the person you want to make healthcare decisions on your behalf if you are unable to communicate. Include their full name, address, phone number, and relationship to you. You may also name an alternate agent.
Document your Living Will preferences
Specify your wishes regarding life-sustaining treatments such as CPR, mechanical ventilation, artificial nutrition and hydration, dialysis, and antibiotics. Indicate under which conditions you want these treatments provided, withheld, or withdrawn.
Add any additional instructions
Include any other healthcare preferences such as organ donation wishes, religious or spiritual considerations, pain management preferences, and specific scenarios not covered by the standard options.
Sign and have the form witnessed
Sign and date the form in the presence of two adult witnesses. The witnesses must also sign the form. At least one witness should not be your designated healthcare agent or a family member.
About VA 10-0137 (VA Advance Directive)
Who needs this form
Any veteran receiving care through the VA healthcare system who wants to document their healthcare preferences and designate someone to make medical decisions if they become unable to do so themselves.
Where to submit
Submit to the VA medical facility where you receive care. The form will be scanned into your VA electronic health record. You should also provide copies to your designated healthcare agent, family members, and personal physician.
Source and content freshness
- Filing deadlines may shift for weekends and holidays. Verify due dates with official instructions.
Common mistakes to avoid
- Not having the form witnessed by two adults (required for validity)
- Choosing a healthcare agent without discussing your wishes with them first
- Not updating the form when your healthcare preferences or agent changes
- Forgetting to distribute copies to your healthcare agent and family
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