VA describes its advance directive as an official document for recording health care preferences, and any VA patient can complete one. Yet many veterans never do, and the gap shows up at the worst moment: a hospital bedside where nobody knows who may speak for the patient. When no agent is named, a doctor chooses a spokesperson from a set order of relatives, and families are left guessing. This guide explains how a health care power of attorney works inside VA Form 10-0137, how it compares with state forms, and the practical steps that help a veteran's wishes be followed in 2026.
Key Takeaways
- Name a trusted adult as health care agent, and an alternate, before a crisis makes the choice for the family.
- Complete VA Form 10-0137 or a valid state form; VA recognizes VA, state, and Department of Defense directives.
- Sign in front of two qualified witnesses, and consider notarization for use outside VA facilities.
- Give the finished directive to the VA health care provider so it can be placed in the medical record.
- Share copies with the agent and family, and keep one where relatives can find it quickly.
- Review the directive after marriage, divorce, a move, a new diagnosis, or a change in the agent's situation.
Table of Contents
- Who Can Complete a VA Advance Directive and Name an Agent
- What to Gather Before Completing the Form
- Choosing the VA Form, a State Form, or Both
- Five Steps to Put a Directive in Place
- After Signing: Keeping the Directive Working
- Frequently Asked Questions
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Who Can Complete a VA Advance Directive and Name an Agent
Many veterans assume an advance directive is only for the very ill or the very old. VA treats it differently. According to VA, any VA patient can complete an advance directive, and doing so is optional. The paperwork matters most before a crisis, because a directive speaks only when the patient cannot decide alone, and by then it is too late to write one.
The pain point is easy to picture. A veteran is hospitalized, unable to answer questions, and relatives disagree about what treatment is wanted. Without a named agent, VA says the doctor selects a spokesperson in a set order: legal guardian, spouse, adult child, parent, sibling, grandparent, grandchild, or close friend. If no one is found, VA staff or a court makes decisions. That fixed order may not match what the veteran would have chosen, such as a trusted friend ranking behind a relative the veteran rarely sees.
Who Can Serve as a Health Care Agent
VA says a veteran can name any adult as a health care agent, ideally someone who knows the veteran well, is trusted, and has agreed to take the role. The VA form also allows an alternate agent in case the first choice is not available. The form lists the agent's authority: making health care decisions, including admission to and discharge from facilities, starting or stopping treatment, and accessing personal health information and medical records.
Because that authority is broad, the choice deserves real thought and a direct conversation before any signature. Naming a spouse out of habit, without asking whether the spouse is willing and able, is a common mistake. An adult child who lives nearby or a close friend may fit better for some families. The same person does not need to fill every legal role, since a health care agent, a financial agent, and an executor can be three different people.
What to Gather Before Completing the Form
A directive is only as useful as the thought behind it. Gathering the right information first turns a blank form into clear instructions. VA's form can be completed in part, so a veteran may fill in some sections, none, or all of them. VA also states that a directive is used only when the patient cannot make decisions, which means the document can sit quietly until it is truly needed.
The form encourages veterans to talk with the health care team, family, and loved ones. Those conversations often matter as much as the paper itself, because an agent who has heard the veteran's wishes can speak with confidence.
Personal and Contact Details
Start with full legal names, addresses, and phone numbers for the veteran, the primary agent, and the alternate agent. Confirm that each person agreed to serve. Note who else should receive copies, such as adult children or a spouse. Keep a short list of the VA primary care provider and any private doctors, since both may need the document.
VA Form 10-5345 is a different form, used for general permission to share health records with others. A VA staff member can explain whether it also fits the situation.
Treatment Wishes and Values
The living will part of the VA form asks about life-sustaining treatments such as CPR, a breathing machine, dialysis, and a feeding tube, in different situations. For each, the veteran initials yes, not sure, or no. Optional sections cover mental health care and additional preferences, and one asks whether the wishes should be a general guide or followed strictly even if the decision-maker disagrees.
VA notes that help is available from a VA social worker, primary care doctor, or mental health professional, and a spiritual advisor or attorney can also help. Writing a few plain sentences about what matters most, such as staying independent or avoiding long hospital stays, gives the agent context that checkboxes cannot.
Choosing the VA Form, a State Form, or Both
A common question is which form to use. VA says it recognizes VA, state, and Department of Defense advance directives, and a veteran may complete VA Form 10-0137 or any valid state form. That flexibility helps, but it creates a pain point: a document that works smoothly in a VA hospital may not carry the same weight in a community hospital, and the reverse can also be true.
Whichever route is chosen, the documents should agree. If a state form names one agent and the VA form names another, staff may not know whom to call. Use the same agent and alternate on every document, and ask both the VA provider and an attorney how to replace an older form when a choice changes.
For more planning ideas, the Protect hub page at avoyvet.com explains how health care directives fit with wills, trusts, and powers of attorney.
How the VA, State, and Military Forms Compare
State directives are legally binding under that state's laws. Some states require a specific form, and some restrict certain language. The VA form says it is valid in VA facilities without notarization, but it may need to be notarized to be legally binding outside the VA health care setting. A Department of Defense directive, drafted by a military lawyer for military personnel, is described by VA as legally binding in VA and in every state.
Rules vary by state, so the safest path for a veteran who receives care in more than one setting is to ask an estate planning or elder law attorney in the state where the veteran lives whether one document is enough or whether two should be coordinated.
Veterans who split time between states, or who spend part of the year with an adult child in another state, should raise that fact with the attorney early. A directive that was valid where it was signed may still be honored elsewhere, but the details differ, and a short review costs far less than a dispute at a hospital.
Five Steps to Put a Directive in Place
Turning intentions into a working document takes only a few steps. The pain point for many families is not complexity but delay: the form stays in a drawer, unsigned, until a hospital stay makes it urgent. The steps below follow the structure of the VA form and are educational, not legal advice.
- Choose a health care agent and an alternate, and confirm that each person is willing to serve.
- Get the current VA Form 10-0137 from VA.gov, or a valid form for the veteran's state.
- Complete the sections wanted, discussing treatment choices with the care team and family.
- Initial and sign the form in front of two qualified witnesses, and consider notarization.
- Give the finished directive to the VA health care provider, the agent, and family members.
Signing, Witnesses, and Notarization
On VA Form 10-0137, the veteran initials the sections completed, initials and dates any attached pages, and signs the form. Two witnesses must also sign. VA's form says a witness cannot be the appointed health care agent, a named beneficiary in the veteran's estate, or financially responsible for the veteran's care. If a physical impairment prevents signing, the form allows someone present to sign at the veteran's direction, or the veteran may use an X, thumbprint, or stamp.
Notarization is optional for use inside VA, yet it may be needed for the document to be legally binding elsewhere. A state form may have its own witness and notary rules, so check the instructions on that form.
Getting the Form Into the Medical Record
VA says the completed directive should be given to the VA health care provider so it can be placed in the medical record. Copies should also go to the health care agent and anyone else who may be involved in decisions. The VA form text does not explain how to update or replace an earlier directive, so a veteran who wants to make a change should ask the VA provider or a social worker how it is handled at that facility.
A veteran who also receives care outside VA should hand copies to those providers as well, since records at one system are not automatically visible in another.
After Signing: Keeping the Directive Working
A signed directive helps no one if nobody can find it or if it no longer matches the veteran's life. The pain point shows up when relatives arrive at a hospital and discover that the named agent has moved, passed away, or is no longer the person the veteran trusts. VA states that an advance directive is used only when the patient cannot decide, so keeping it current is what makes it dependable at that moment.
Share and Store Copies
Give copies to the primary and alternate agents, close family, and the VA health care team. Keep the original where relatives can reach it quickly, and tell them where it is. Many veterans also store a copy with other estate planning papers, such as a will or trust, so an attorney can see the whole plan. Telling the agent about the veteran's wishes in person is the strongest backup of all, since a conversation can fill gaps that the form cannot.
Review After Major Life Changes
Review the directive after marriage, divorce, the death or illness of an agent, a move to another state, or a new diagnosis. State rules differ, and a form signed years ago in one state may need to be checked against the laws of the state where the veteran now lives. Because rules vary by state, an estate planning or elder law attorney can confirm that the documents still work together.
Reviewing also gives the veteran a chance to repeat the conversation with the agent. Wishes change over time, and an agent who last heard them a decade ago may be guessing.
A simple habit helps: pick a date each year, such as a birthday or the anniversary of signing, to reread the directive, confirm the agent is still willing, and ask the VA care team whether anything in the record needs attention.
Ready for the Next Step?
Not sure where a health care directive fits in the bigger picture? Take the free Veteran Legacy Checklist at avoyvet.com, then ask AVOY Veteran Navigator AI for educational guidance on planning, benefits, and family protection.
Frequently Asked Questions
Is a VA advance directive required for veterans enrolled in VA health care?
No. VA states that completing an advance directive is optional for any VA patient. Many veterans still choose to complete one because it records preferences and names an agent before a medical crisis. Without a directive, VA says the doctor selects a spokesperson in a set order, starting with a legal guardian and then a spouse, adult child, parent, sibling, grandparent, grandchild, or close friend. If no one can be found, VA staff or a court may decide. A directive lets the veteran choose the decision-maker personally instead of leaving the choice to that order. The form can also be completed in part, so a veteran may fill in only the sections that matter most.
Does a health care agent have authority at any time?
No. VA explains that an advance directive is used only when the patient cannot make decisions. While the veteran can understand information and communicate choices, the veteran remains the decision-maker. The VA form describes the agent's authority as making health care decisions, including admission to and discharge from facilities, starting or stopping treatment, and accessing personal health information and medical records. That authority begins only when the veteran is unable to decide. Because the role is broad, the veteran should choose someone trusted, confirm that the person agrees to serve, and share the veteran's wishes in advance. An alternate agent can be named for times when the first choice is unavailable.
Will a VA advance directive work in a community hospital?
It depends. The VA form states that it is valid in VA facilities without notarization, but it may need to be notarized to be legally binding outside the VA health care setting. State directives are legally binding under that state's laws, and some states require a specific form. Rules vary by state, so a veteran who receives care both inside and outside VA may want to ask an estate planning or elder law attorney whether one document is enough. Keeping the same agent on every document and giving copies to each provider reduces confusion. A Department of Defense directive is described by VA as binding in VA and in every state.
Who is not allowed to witness VA Form 10-0137?
Two witnesses must sign the form. According to VA's form, a witness cannot be the appointed health care agent, a named beneficiary in the veteran's estate, or financially responsible for the veteran's care. A witness also cannot be the third party who signed at the veteran's direction. These limits exist so the people confirming the signature have no personal stake in the choices. Many veterans ask neighbors, friends, or coworkers who are not relatives or heirs. A state form may carry different witness rules, so the instructions on that form should be read before signing. A VA social worker or an attorney can answer questions about who qualifies.
What happens when a veteran names no health care agent?
VA says the doctor selects a spokesperson from a set order: legal guardian, spouse, adult child, parent, sibling, grandparent, grandchild, or close friend. If no one is found, VA staff or a court makes decisions. This process can work well when family members agree, but it can cause stress when relatives disagree or when the person the veteran would trust most is not at the top of the order. Naming an agent on the directive removes that guesswork. Many veterans also name an alternate agent so that someone is always available. The decision stays with the veteran, not with a default list.
Is notarization required for a VA advance directive?
Not for use inside VA. The VA form states that it is valid in VA facilities without being notarized. Outside the VA health care setting, though, notarization may be needed for the document to be legally binding. A state form may require a notary, witnesses, or both, and those rules vary by state. Because notarization is usually inexpensive and widely available, many veterans add it for extra protection, especially when they use private doctors or hospitals. A bank, a local library, or an attorney's office often has a notary. A veteran who is unsure which rules apply should ask an attorney in the state where the veteran lives.
Is a lawyer needed to complete a VA advance directive?
No. VA says veterans can fill out VA Form 10-0137 or any valid state form, and help is available from a VA health care professional such as a social worker, primary care doctor, or mental health professional. A spiritual advisor can also help with the values behind the choices, and the veteran should discuss the plan with family. An attorney is optional, but one can be valuable when a veteran wants the directive to work smoothly with a will, trust, or financial power of attorney, or when care is received in more than one state. An estate planning or elder law attorney can explain local witness and notary rules.
Educational information only — not legal, tax, financial, medical, or claim advice or representation, and not affiliated with the U.S. Department of Veterans Affairs. For help filing or appealing, contact a VA-accredited VSO (often free), claims agent, or attorney. For current rates, forms, and deadlines, see VA.gov.
