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How to Complete a Request for Service

  1. Download the Request for Service (RFS) form.
  2. Complete the form.
  3. Fax RFS form to your specific VAMC Community Care Network Department.

The VA will begin to require providers to use the HealthShare Referral Manager system. Check with your local leadership on the timing of this change.

DOWNLOAD REQUEST FORM

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WHAT IS FREESPIRA®?

FREESPIRA’S MISSION IS TO PROVIDE A SAFE AND MEDICATION-FREE TREATMENT TO SUPPORT AMERICA’S VETERANS STRUGGLING WITH SYMPTOMS ASSOCIATED PTSD AND PANIC DISORDER.

Freespira is an FDA-cleared, in-home treatment. It is an option that can be used along with talk therapy and medication, or on its own. Once authorized, Freespira ships your patient a sensor, a small breath sampling tube and a tablet with an app. The treatment corrects irregular breathing patterns, a physiologic factor of repeated anxiety attacks, and trains the body to reduce or eliminate them.

OUR PARTNERS

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We are honored to be listed on the Federal Supply Schedule (36F79718D0519), through our SDVOSB partner Franklin Young International, Inc.

FSS: 36F797-20-D-0158
GSA FSS: GS-07F-0636W

Freespira delivers long-term benefits1

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1 Ostacher MJ, et al., Appl Psychophysiology Biofeedbak. 2021; 10.1007/s10484-021-09521-3
2 Reduction in CAPS-5 of at least 6 points
3 Reduction in CHRT scores
4 Reduction in PHQ-9 scores

89%Clinically Significant Symptom Reduction2
50%In remission at 6 months
41%Decrease in Suicidality3
29%Decrease in Depression4
77%Treatment Protocol Adherence
91%Satisfaction Rate

PTSD disrupts the daily lives of millions of Americans. Yet, traditional medication and counseling therapies often fall short for these sufferers – many of whom have begun to believe that there is no hope for relief or remission. Innovative drug-free approaches, like Freespira, that address the underlying physiological symptoms of PTSD provide a new solution – and new hope – to this problem.

— Honorable David J. Shulkin, M.D., Ninth Secretary of the US Department of Veterans Affairs

Since completing Freespira, I am able to control my anger, and I am not as depressed anymore. I’ve learned to cope better and am functioning well. I enjoy family activities again, and my family enjoys being around me, too. Freespira gave me an outlet to control my symptoms, so I am able to function in everyday life.

— Gary, Sergeant First Class, United States Army

NEED HELP?

Freespira’s team of clinicians and advisors are here to support you
and help navigate the VA authorization process.

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CALL US

+1 800.735.8995

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EMAIL US

VA@Freespira.com

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REQUEST A MEETING

Schedule a time