VA Form 10-0137: Advance Directive, Health Care Agent, Living Will

VA Form 10-0137 is the Department of Veterans Affairs advance directive. It lets you name someone to make medical decisions if you lose the ability to decide for yourself and lets you write down your preferences for life-sustaining treatment, mental health care, and long-term care.¹ You can download it from VA.gov, complete it on your own or with help from VA staff, and submit it to your VA facility so it becomes part of your electronic health record.

What the Form Includes

The form has three working parts. Part II is a Durable Power of Attorney for Health Care, where you name a person (your “Health Care Agent”) to make decisions on your behalf. Part III is a Living Will, where you spell out your preferences for life-sustaining treatment. A separate mental health section lets you document preferences for psychiatric care, including specific treatments you do or don’t want.²

You don’t have to complete every part. A veteran who only wants to name an agent can skip the living will section, and someone who only wants to document treatment preferences can skip the agent section.³

Naming Your Health Care Agent

Most veterans should start here, because everything else in the form works better when someone you trust has legal authority to carry out your wishes. You write in the agent’s full name, address, and phone number so VA staff can reach them quickly.² You can also name one or more alternate agents who step in if your first choice is unavailable or unwilling to serve.

Once a VA practitioner determines you lack the capacity to make or communicate your own decisions, your agent gains broad authority. That includes the power to consent to or refuse any medical treatment, to admit or discharge you from a facility, and to access your health records, including mental health treatment records and HIV testing information.² Pick someone who knows your values and whom you trust to make hard calls under pressure. Talk with them before you finalize the form. An agent who first learns your preferences by reading the document in a hospital hallway is not well-positioned to make nuanced decisions the form doesn’t explicitly cover.

The Living Will Section

This section asks what you’d want in four specific scenarios:

Unconscious with little or no chance of recovery, such as coma or a vegetative state.
Severe permanent brain damage, where you can no longer recognize family or friends.
Permanent dependence on a breathing machine, leaving you bedbound for the rest of your life.
Terminal condition that will cause death in the near future even with treatment.

For each scenario, you initial whether you want life-sustaining treatments (such as CPR, mechanical ventilation, dialysis, or a feeding tube) or prefer comfort care only.²

The form then asks how strictly you want these instructions followed. One option treats your preferences as a general guide, giving your agent and doctors some flexibility. The other directs them to follow your choices as closely as possible. This flexibility question matters more than most people realize. Medical situations rarely match the hypothetical scenarios exactly, and a rigid directive can leave your agent and care team in a bind when reality falls between the lines.

If you need more space to explain your reasoning or add conditions the form doesn’t cover, you can attach extra pages. Any attached pages must be initialed and dated, and they’ll be filed together with the main form as a single document.⁴

Mental Health Treatment Preferences

The mental health section is separate from the living will and is meant for veterans whose future decision-making capacity could be affected by a psychiatric condition. You can record your wishes on several types of treatment:

Psychotherapy, and what kind you would accept.
Psychiatric medications you consent to or refuse.
Electroconvulsive therapy (ECT).
Admission or transfer to a mental health unit.
Physical restraint or seclusion if staff believe it’s necessary.

You can also address whether certain treatments or medications can be administered against your wishes if you lack the capacity to make decisions at the time.² This section is particularly useful for veterans managing conditions like PTSD, bipolar disorder, or schizophrenia, where a crisis episode might temporarily remove the ability to communicate clear preferences.

Signing and Witness Requirements

The form isn’t legally effective until it’s properly signed and witnessed. You sign and date it in the presence of two witnesses, and both witnesses must also sign, confirming they saw you put your signature on the document.³

Not everyone can serve as a witness. Federal regulations disqualify three categories of people:

Anyone named as your Health Care Agent or alternate agent in the directive.
Anyone who is financially responsible for your care.
Anyone who, to their knowledge, is named as a beneficiary in your estate.

If someone else signs the form on your behalf, that person also cannot serve as a witness.³ No notarization is needed for the form to be valid at VA facilities.⁵

If You Can’t Sign the Form Yourself

A physical impairment doesn’t have to stop you. If you can’t write your signature, the form accepts an “X” mark, a thumbprint, or a stamp in place of a signature. If none of those work either, you can ask someone present with you to sign or mark the form on your behalf.² That third party signs at your direction and in your presence, and cannot double as one of the two required witnesses.

Help From VA Staff

You have the right to ask for help completing the form, and the VA is required to provide it. Social workers and other trained staff at every VA facility must be available to walk you through the form, explain what different medical scenarios would look like in practice, and help you think through your preferences.⁴ The hypothetical scenarios on the form can feel abstract, and a practitioner who deals with these situations regularly can help you understand what each one would actually mean for your care.

Getting the Form Into Your VA Record

Once the form is signed and witnessed, deliver it to your VA facility so it becomes part of your electronic health record. You can hand it to your primary care team or submit it through the facility’s medical records department. Another option is to sign in to My HealtheVet, send a secure message to your care team with the directive attached, and ask them to upload it to your record.⁶

Keep a copy for yourself and give copies to your Health Care Agent and any alternate agents. An advance directive buried in a filing cabinet at home doesn’t help anyone if you’re admitted to a VA hospital in a different city.⁷

Changing or Canceling Your Directive

You can cancel or change your advance directive at any time, as long as you have the capacity to make that decision. The standard is broad: any action that expresses your intent to revoke counts.⁴ Telling your doctor you want to cancel, writing a signed statement, or destroying the document all work.

To update your preferences rather than cancel entirely, complete a new VA Form 10-0137. The VA doesn’t allow edits to an existing form. Once a new directive is entered into your record, all previous versions are automatically invalidated. After any change, give a copy of the new directive to your VA facility and to your Health Care Agent.⁷ Life events like a divorce, a falling out with your named agent, or a change in your health status are reasons to revisit the form. Nothing in VA policy automatically revokes your directive based on a change in marital status, so if your ex-spouse is still listed as your agent and you don’t file a new form, they keep that authority.

How It Works With Non-VA Hospitals

The VA recognizes all types of legal advance directives, including state-authorized forms and Department of Defense advance medical directives.³ A valid advance directive from any state will be honored throughout the VA health care system, as long as its provisions don’t conflict with federal law or VA policy.

The reverse is worth knowing. VA Form 10-0137 is designed for VA care, and may or may not be legally binding at private hospitals, depending on your state’s laws.⁸ If you receive care both inside and outside the VA system, consider filling out a state advance directive alongside the VA form. Make sure the two documents don’t contradict each other. Getting the VA form notarized is a reasonable precaution if you want it to carry more weight outside the VA, since some states require notarization for advance directives to be enforceable.

What Happens Without an Advance Directive

If you become unable to make decisions and don’t have an advance directive on file, VA staff will look for a surrogate decision-maker using a set priority list, in this order:

A legal guardian a court has already appointed.
Spouse.
Adult child.
Parent.
Sibling.
Grandparent.
Grandchild.
A close friend, age 18 or older, who has demonstrated care and concern for your welfare and is familiar with your values and beliefs.

The VA works down this list in order and contacts the first available person within 24 hours of determining you lack capacity.⁹ A surrogate who wasn’t chosen by you and hasn’t discussed your values with you is guessing, even with the best intentions. Completing VA Form 10-0137 removes that guesswork.

1
Veterans Affairs. About VA Form 10-0137
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Department of Veterans Affairs. VA Form 10-0137 Advance Directive
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eCFR. 38 CFR 17.32 – Informed Consent and Advance Directives
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Department of Veterans Affairs. VHA Handbook 1004.02 – Advance Care Planning and Management of Advance Directives
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VA.gov. VA Form 10-0137 VA Advance Directive
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My HealtheVet. Who Will Control Your Health Care
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VA.gov. What You Should Know About Advance Directives
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VA.gov. What You Should Know About Advance Directives
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U.S. Department of Veterans Affairs. Incapacitated, Socially Isolated Veterans In Need of Surrogates