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About VA Form 10-0137

Form name: VA Advance Directive: Durable Power of Attorney for Health Care and Living Will
Form revision date: August 2021
Related to: Health care

When to use this form

Use VA Form 10-0137 to give specific people permission to make health care decisions for you, and to let VA health care providers know your wishes for medical, mental health, long-term, and other types of care.

Downloadable PDF

  • VA Form 10-0137 Spanish-English

    Form name: Directrices Anticipadas De Va Poder Legal Para La Designacion De Agente Para El Cuidado De Salud Y Testamento En Vida

    Usted puede utilizar este formulario para: 

    • Designar personas específicas que tomen decisiones sobre su cuidado de salud por usted. 
    • Describir las preferencias sobre como usted desea ser tratado(a).
    • Describir sus preferencias sobre su cuidado médico, cuidado de salud mental, cuidado a largo plazo, u otros tipos de cuidado de salud. 

  • VA Form 10-0137A

    Form name: What You Should Know About Advance Directives

    Use this form to learn about your rights to accept or refuse medical treatment, and to complete a power of attorney for health care or a living will. 

Helpful links related to VA Form 10-0137

  • Read about your basic rights and responsibilities when you receive care at a VA health facility or live in a VA community center.

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