This VA HVAC Design Manual for the Department of Veterans Affairs (VA) Healthcare Facilities is the only detailed design requirements manual for VA. The original 2017 version has been edited several times since first publication to keep the information updated and synchronized with the latest industry trends. VA lessons learned, collected from VHA clinicians and operations personnel, have been incorporated as well. The November 1, 2021 revision of this manual includes high priority changes recommended by the VA CFM/VHA HVAC committee in response to the COVID-19 pandemic.