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The OMB Control No. for this information collection is 2900-0556. VA FORM JUL 2015 10-0137 Page 1 of 7 PART II DURABLE POWER OF ATTORNEY FOR HEALTH CARE This section of the advance directive form is called a Durable Power of Attorney for Health Care. OMB Approval Number 2900-0556 Estimated Burden Avg 30 minutes Expiration Date 10/31/2017 VA ADVANCE DIRECTIVE DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND LIVING WILL This advance directive form is an official document where you can write down your preferences for your health care. I am not financially responsible for the care of the person making this advance directive. To the best of my knowledge I am not named in the person s will. Name Printed or Typed This VA Advance Directive form is valid in VA facilities without being notarized. However you may need to have it notarized to be legally binding outside the VA health care setting. DATE SIGNATURE B - WITNESSES SIGNATURES Two people must witness your signature. VA employees may be witne....

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How to fill out the VA 10-0137 online

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.

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Related content

VA Form 10-0137 - Veterans Affairs
This site provides public access to all VA forms that are appropriate to be on the web.
Learn more
VA ADVANCE DIRECTIVE: DURABLE POWER OF ...
VA FORM. DEC 2006 (RS) 10-0137. Page 1 of 6. This advance directive form is an official...
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You must sign the Power of Attorney, but you do not need witnesses to your signature. You should have your signature notarized. ... If you had a Power of Attorney prepared while you were living in another state or country and you have now moved to Virginia, that document might be legal under Virginia law.

Most states do accept living wills from other states as long as the document is valid in the state in which it was created, but not all do, so it is important to check when your living will is created.

According to VA: The veteran must execute a general or specific power of attorney (POA) which is valid and legally adequate. The veteran's attorney-in-fact may use this power of attorney to apply for a Certificate of Eligibility and initiate processing of a loan on behalf of the veteran.

If filing claims with the VA, the federal regulations are available here. The VA, however, will accept a power of attorney as valid for health care decision-making purposes, even if it is not notarized, if VA Form 10-0137, VA Advance Directive: Durable power of attorney for Health Care and Living Will, is completed.

A VA Form 21-22a is known as an Appointment of Individual as Claimant's Representative form. It will be used by the United States Department of Veterans Affairs. This form is necessary to recognize someone as a representative of a veteran who has a claim with the Department of Veterans Affairs.

A VA Form 10-0137 is used by the Veterans Health Administration (VHA), United States Department of Veterans Affairs. This form is known as a VA Advance Directive: Living Will and Durable Power of Attorney for Health Care. ... Before filling out this form, consult your medical professional and talk to your loved ones.

VA makes financial planning and online will preparation services available at no cost to beneficiaries of: SGLI (Servicemembers' Group Life Insurance) TSGLI (Traumatic Injury Protection)

VA Form 10-0137 allows a veteran to select a representative to serve as a power of attorney for health care and a living will. A durable power of attorney usually must be signed and notarized, as well as specified as being durable; it will continue to be in effect in the event the principal becomes incapacitated.

Power of Attorney (POA) is a familiar concept for many VA buyers. POA is a legal instrument allowing service members to designate a person who can enter into contracts and execute other civil, financial and legal obligations on their behalf - often because of a deployment.

VA makes financial planning and online will preparation services available at no cost to beneficiaries of: SGLI (Servicemembers' Group Life Insurance) TSGLI (Traumatic Injury Protection) ... VGLI (Veterans' Group Life Insurance)

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