D.3 ATTACHMENT C SAMPLE REFERRAL LANGUAGE_Sept 22, 2025.docx

D.3 ATTACHMENT C SAMPLE REFERRAL LANGUAGE

Dear (name of Veteran or Primary Caregiver), Thank you for utilizing VA’s Caregiver Support Program’s contracted legal and/or financial planning services provided through [insert contractor name_____________________].

You have requested assistance for the following service(s):

(list specific services being referred in this instance such as Simple Will, POA, etc.)

A referral to (name of provider) has been initiated for this service.

If you are in need of additional services, please consult with your Concierge for a new (additional) referral prior to discussing with an attorney or financial counselor.

Please Note: If you need to continue your chosen services with an attorney or financial counselor after three consultations or for services not covered where you receive a referral to community resources, it will be at your own expense. You may continue with the same attorney or choose a new one. However, these additional services will be outside the Department of Veterans Affairs’ responsibility. Your legal/financial concierge can assist with your referral needs.

Each of the services listed below may only be used once in a 12-month period, and you must receive a referral through your Concierge prior to utilizing the service.

Legal services include up to three sessions with an attorney (for specific covered topics listed below), with each session lasting no longer than 30 minutes:

· Drafting of a Simple Will

· Drafting of an Advanced Directive (also known as Durable Health Care Power of Attorney, Medical Power of Attorney, or Living Will, depending on your state of residence)

· Drafting of Power of Attorney

· Drafting of Durable Financial Power of Attorney

· Drafting of a Durable Power of Attorney for Healthcare

· Drafting of Guardianship instruments (for guardianship of the Veteran without court representation)

· Identity Theft 90-day restorative services

· Civil dispute assistance with up to two letters and/or two phone calls made or received by an attorney (for topics such as contract disputes, defaults on loans, insurance issues, neighbor disputes, product liability, warranties, collections, garnishments)

· One single 30-minute consultation with an attorney for limited civil issues not covered above

Financial planning services include up to three sessions with a financial counselor for support/consultation (for specific covered topics listed below), with each session lasting no longer than 30 minutes:

· Household Budgeting

· Debt Management

· Retirement Planning Review and Education

· Insurance Review and Education

· Education on Mortgage loans and refinancing

· Extensive Financial coaching - 90-day telephonic coaching

· Education on Credit Management

Services that are NOT covered and, if pursued, would incur an out-of-pocket cost to you include, but are not limited to:

· Drafting estate planning documents beyond a simple will (complex will, trust, or other estate planning documents)

· In-person court representation

· Processing the drafted Guardianship instruments through the court to completion

· Retaining an attorney to complete other civil issues beyond what is listed above