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Virginia advance directive printable form

Va form 10 0137-2026

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The document is a VA Advance Directive form that allows individuals to outline their health care preferences in case they become unable to make decisions for themselves. It includes sections for appointing a Health Care Agent, specifying preferences for life-sustaining treatments, and detailing mental health and additional care preferences. The form emphasizes the importance of discussing these choices with family and healthcare providers and provides instructions for completion, including signature requirements.

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Click ‘Get Form’ to open VA Form 10-0137 in the editor.
Begin with Part I: Personal Information. Fill in your name, date of birth, address, and phone numbers. Ensure all details are accurate for proper identification.
Move to Part II: Durable Power of Attorney for Health Care. Here, you can appoint a Health Care Agent by placing your initials next to your choice and providing their contact information.
If desired, designate an Alternate Health Care Agent by completing the relevant section with their details.
Proceed to Part III: Living Will. Indicate your preferences regarding life-sustaining treatments by initialing the appropriate boxes based on your wishes.
Complete any optional sections for mental health preferences and additional preferences if applicable.
In Part IV, sign and date the form. Ensure two witnesses sign as well, confirming they observed you signing the document.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (229 Votes)
2020	4.3 Satisfied (77 Votes)
2015	4.4 Satisfied (288 Votes)
2012	4 Satisfied (43 Votes)
2011	4.2 Satisfied (29 Votes)
2006	3.9 Satisfied (52 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the hardest VA claim to get?

What is the Hardest VA Claim to Get? Mental Health Conditions (e.g., PTSD, Depression) Sleep Apnea. Tinnitus and Hearing Loss. Military Sexual Trauma (MST) Chronic Pain Without a Clear Diagnosis.

What should you know about advance directives VA?

In a VA advance directive, you can say how strictly you want your wishes followed. You can tell your health care agent to do just what your living will says, or you can tell them to make the decision they think is best for you even if it isnt what the living will says.

How to submit a VA form?

The best way to file for disability compensation is to apply online at .va.gov/disability. Or, you can fax it to: (844) 531-7818 (inside the U.S.) (248) 524-4260 (outside the U.S.)

What is the order of surrogate priority in Virginia?

If you dont choose a Health Care Agent to be your surrogate and you lose the ability to make decisions for yourself, your surrogate will be identified from this list, in the following order of priority: legal guardian (if you have one), spouse, adult child, parent, sibling, grandparent, grandchild, or a close friend.

What is the VA nearest living relative form?

The VA Nearest Living Relative Statement is a document used by the Department of Veterans Affairs to identify the nearest living relative of a veteran, which is necessary for certain benefits and notifications.

va form 10 0137 printable

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Is it better to file a VA claim online or in person?

You or someone else can provide lay evidence in any of these ways: Write and submit a statement about your situation on a blank piece of paper. Complete and submit a Lay or Witness Statement (also known as a buddy statement) (VA Form 21-10210) Complete and submit a Statement in Support of Claim (VA Form 21-4138)