Refer your PTSD or panic disorder patient

GET STARTED

How to Complete a VA Request for Services (RFS) Form

Complete the Request for Services (RFS) Form.
Click Submit once complete.
Or, you can also download the RFS form, and fax the completed form (along with the most recent clinical notes) to Freespira at 1.844.824.8779.

Once you've completed the form, we will fax it directly to the VA to get your patient's referral started. We will notify you once we receive approval. If we have any questions or need more information, we may reach out to you via phone or email.

If you have any questions, please reach out to us directly at care.advisor@freespira.com or 1.800.735.8995.

HOW WE WORK

What is Freespira?

Freespira's mission is to provide a safe and medication-free treatment to support America's Veterans struggling with symptoms associated with PTSD and panic disorder.

Freespira is an FDA-cleared, at-home medical device that addresses dysfunctional breathing, which plays an important role in panic and PTSD. It is an adjunctive treatment that can be incorporated into the patient’s care plan along with psychotherapy and/or medication. Once approved by the VA, Freespira ships the medical device to the patient’s home.

who we work with

Our partners

We are honored to be listed on the Federal Supply Schedule 65 II A, #V797D-5045, through our SDVOSB partner Lovell Government Services.

SURVEY RESULTS

Freespira delivers long-term benefits¹

"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

Watch Talia’s story and learn how she became panic attack-free with Freespira.

"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, Retired

Need help?

The Freespira team is here to support you and help navigate the VA authorization process.