Get Va 10-0137 2020-2025

The VA 10-0137 form is an essential document that allows individuals to express their health care preferences in the event they are unable to make decisions. This guide will provide you with clear, step-by-step instructions for completing this important form online.

Follow the steps to successfully complete the VA 10-0137 online.

1. Click ‘Get Form’ button to obtain the form and open it in your online editing tool.
2. In Part I, provide your personal information, including the last four digits of your Social Security number, your name, address, and phone numbers. Ensure all details are entered accurately.
3. Move to Part II and appoint a Health Care Agent. If you wish to designate someone, fill in their details, including their relationship to you. If you do not wish to appoint anyone, indicate that by placing your initials in the appropriate box.
4. If you want an alternate Health Care Agent, complete that section by providing their details as well.
5. In Part III, outline your Living Will preferences. Review each treatment scenario and indicate your preferences by placing your initials in the corresponding boxes.
6. Optional: If you wish to specify preferences regarding mental health care, complete the section dedicated to mental health preferences.
7. In the Additional Preferences section, you can add any other important considerations for your health care.
8. Indicate how strictly you want your medical preferences to be followed by placing your initials in the appropriate box.
9. In Part IV, sign the form to certify that it accurately represents your choices. Include today's date.
10. Having two witnesses sign the document is necessary to validate it. Ensure they provide their signature, printed name, and address in the designated areas.
11. Lastly, review your form to ensure completeness, and if necessary, notarize the document as required for legal enforcement outside VA health care settings.
12. Once completed, you can save your changes, download the form for your records, print a hard copy, or share it as needed.

Start filling out your VA 10-0137 online today to ensure your health care preferences are documented and respected.