Va form 10 0137-2026

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 by filling out Part I: Personal Information. Enter your last four digits of SSN, name, address, and phone numbers in the designated fields.
Move to Part II: Durable Power of Attorney for Health Care. Decide if you want to appoint a Health Care Agent. If yes, provide their details and initial the box next to your choice.
If desired, appoint an Alternate Health Care Agent by filling out the corresponding section with their information and initials.
Proceed to Part III: Living Will. Indicate your preferences regarding life-sustaining treatments by placing your initials in the appropriate boxes for each situation described.
Complete any optional sections for mental health preferences and additional preferences as needed, ensuring you initial any attached pages.
In Part IV: Signatures, sign and date the form. Ensure two witnesses sign as well, confirming they meet the criteria outlined in the instructions.

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Versions	Form popularity	Fillable & printable
2024	4.5 Satisfied (35 Votes)
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)
1998	4.8 Satisfied (54 Votes)