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About VA Form 10-0137A

Form name: What You Should Know About Advance Directives
Related to: Health care
Form last updated: March 21, 2020

When to use this form

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. 

Downloadable PDF

Download VA Form 10-0137A (PDF)
  • VA Form 10-0137

    Form name: VA Advance Directive: Durable Power of Attorney for Health Care and Living Will

    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.

    Download VA Form 10-0137 (PDF)
  • 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. 
    Download VA Form 10-0137 (espanol) (PDF)
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