About VA Form 10-0137
- Form name: VA Advance Directive: Durable Power of Attorney for Health Care and Living Will
- Related to: Health care
- Form last updated: March 2022
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
Download VA Form 10-0137 (PDF)Related forms and instructions
-
VA Form 10-0137 (espanol)
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.
Download VA Form 10-0137A (PDF)
Helpful links related to VA Form 10-0137
-
Patient rights and responsibilities
Read about your basic rights and responsibilities when you receive care at a VA health facility or live in a VA community center.