TRICARE Home Health Care in Frisco and Carrollton, TX — Coverage, Plans, and How to Start

Military families stationed near Joint Base Fort Cavazos, reservists drilling in the Dallas–Fort Worth corridor, and retirees who chose Denton or northwest Dallas County for their post-service chapter all share a common question: Does TRICARE cover home health care, and how do I actually use it here in Frisco or Carrollton? The short answer is yes — but the details depend on your plan, your beneficiary category, and whether you need a referral or prior authorization. This guide walks you through every step so you can turn TRICARE eligibility into real care delivered inside your own home.

What Is TRICARE?

TRICARE is the health-care program of the United States Department of Defense (DoD), not the Department of Veterans Affairs. That distinction matters because TRICARE covers active-duty service members, their dependents, National Guard and Reserve members, military retirees, and certain survivor-beneficiaries — while VA health care is limited to veterans who meet separate enrollment criteria. If you carry a TRICARE card, your benefits originate through the Defense Health Agency, not through the VA hospital system.

Because Texas falls entirely within the TRICARE East Region, your regional managed-care support contractor is Humana Military. Humana Military processes claims, maintains the provider network, handles prior authorizations, and manages the referral pipeline for beneficiaries enrolled in managed-care options such as TRICARE Prime.

TRICARE Plan Types and Home Health Eligibility

Not every TRICARE plan works the same way when it comes to home health. Below is a breakdown of the most common plan categories and what each one means for accessing skilled nursing care at home and related services in the Frisco–Carrollton area.

TRICARE Prime

TRICARE Prime is the managed-care option that functions most like an HMO. Active-duty service members are automatically enrolled in Prime at no cost. Dependents and retirees can enroll for an annual enrollment fee. Under Prime, you are assigned a primary-care manager (PCM) who must issue a referral before you can see specialists or receive home health services. Humana Military then processes a prior authorization for home health care. Once authorized, there is typically no copay for active-duty family members and a modest per-visit copay for retirees.

TRICARE Select

TRICARE Select is the preferred-provider option that resembles a PPO. You do not need a referral from a PCM — you can self-refer to any TRICARE-authorized provider. However, you will pay cost-shares that vary depending on whether you are an active-duty family member or a retiree group beneficiary. Home health visits from a network provider are generally covered at a lower cost-share than out-of-network providers.

TRICARE For Life (TFL)

TFL is the Medicare wraparound coverage available to TRICARE beneficiaries who are entitled to Medicare Part A and enrolled in Medicare Part B. When you turn 65 and pick up Medicare, TRICARE For Life acts as a secondary payer. For home health services, Medicare pays first under its home health benefit, and TFL picks up most of the remaining balance. This is the scenario many military retirees in Frisco, Carrollton, Highland Village, and Lewisville encounter as they age into Medicare eligibility.

TRICARE Reserve Select (TRS)

TRS is available to qualified members of the Selected Reserve and their families. It functions similarly to TRICARE Select, with monthly premiums and cost-shares. Home health care is a covered benefit, subject to standard cost-sharing.

TRICARE Young Adult (TYA)

TYA extends coverage to adult children of TRICARE-eligible sponsors up to age 26. It is available in Prime and Select variants. Home health care is covered under both options, following the same referral and authorization rules as the parent plan type.

Cost-Sharing for Home Health Care by Plan

TRICARE Plan	Referral Required?	Prior Authorization?	Active-Duty Family Cost	Retiree / Other Cost
Prime	Yes (from PCM)	Yes (Humana Military)	$0 per visit	$12 per visit (network)
Select (ADFMs)	No	Yes	$0 per visit (network)	N/A
Select (Retirees)	No	Yes	N/A	20% cost-share (network)
For Life	No	Medicare rules apply	N/A	$0 after Medicare pays
Reserve Select	No	Yes	15% cost-share (network)
Young Adult (Prime)	Yes	Yes	Same as Prime retiree tier
Young Adult (Select)	No	Yes	Same as Select retiree tier

Note: Copays and cost-shares are subject to annual deductible and catastrophic cap limits. Verify your specific cost obligations at tricare.mil or by calling 1-800-444-5445.

TRICARE Is Not the VA — Why the Distinction Matters

We frequently hear from families in The Colony, Little Elm, and Addison who assume that "military insurance" automatically means the VA. TRICARE and VA health care are separate systems administered by different federal departments. A retired Army NCO living in Carrollton who receives TRICARE Select benefits does not need to enroll in VA health care to use those benefits — and a veteran enrolled at the VA North Texas Health Care System in Dallas cannot use their VA enrollment to access TRICARE-network providers unless they also hold TRICARE eligibility.

If you are a veteran who also qualifies for TRICARE (for example, a military retiree with 20 or more years of service), you may carry both benefits simultaneously. In those cases, coordination of benefits determines which payer is primary. Families exploring veterans home care benefits should carefully determine which program — TRICARE, VA, or both — applies to their situation.

The Authorization Process: From Doctor's Order to First Visit

Getting TRICARE-authorized home health care in the Frisco–Carrollton area follows a predictable sequence. Here is how the pipeline works from initial medical need to the first nurse walking through your front door.

Step 1 — Medical Necessity Determination

Home health care under TRICARE requires a physician's order establishing medical necessity. You must be homebound or have a condition that makes receiving care outside the home a significant hardship. Your physician — whether a military treatment facility (MTF) provider or a civilian TRICARE-network doctor — documents the diagnosis, the skilled services required, and the anticipated duration of care.

Step 2 — Referral (Prime Beneficiaries Only)

If you are enrolled in TRICARE Prime, your primary-care manager must issue a referral. Select beneficiaries skip this step. The referral is transmitted electronically to Humana Military.

Step 3 — Prior Authorization from Humana Military

Humana Military reviews the referral and physician's order, confirms beneficiary eligibility and the clinical justification, and issues an authorization number. This authorization specifies which services are approved, how many visits, and over what time frame. BrightStar Care of Frisco/Carrollton handles the administrative coordination with Humana Military so you do not have to chase paperwork.

Step 4 — RN Assessment and Plan of Care

Once authorization is in hand, a registered nurse conducts an in-home assessment. The RN evaluates your condition, reviews medications, assesses fall risks, and builds a formal plan of care that aligns with the physician's orders and the TRICARE authorization scope.

Step 5 — Services Begin

Skilled nursing visits, personal care and bathing assistance, physical therapy, occupational therapy, speech-language pathology, and home health aide support can all begin according to the approved plan of care. Your care team coordinates directly with your physician and Humana Military for re-authorizations as needed.

Post-Surgical Home Health for TRICARE Beneficiaries in Frisco and Carrollton

One of the most common triggers for home health care is a hospital discharge after surgery. TRICARE beneficiaries in the Frisco–Carrollton corridor have access to several major hospitals where surgical procedures frequently lead to home health referrals:

• Baylor Scott & White Medical Center – Frisco — joint replacement, spinal procedures, cardiovascular surgery
• Medical City Frisco — orthopedic and general surgical cases
• Texas Health Presbyterian Hospital Denton — cardiac rehabilitation referrals, complex medical discharges
• Medical City Lewisville — post-surgical wound management, IV therapy transitions
• Baylor Scott & White Medical Center – Carrollton — same-day and short-stay surgical aftercare

When a TRICARE beneficiary is discharged from any of these facilities, the hospital discharge planner can initiate the home health referral on the same day. Our hospital-to-home transitional care program ensures continuity between the inpatient team and the home health team — preventing gaps that lead to readmissions.

Military Retirees in the Denton–Dallas County Corridor

The suburbs stretching from Highland Village south through Lewisville, Carrollton, and Addison have become a magnet for military retirees. The combination of no state income tax, proximity to DFW International Airport for Space-A travel, excellent medical infrastructure, and a cost of living below the national metro average makes the Frisco–Carrollton corridor one of the most attractive retirement destinations for career military personnel in the Southwest.

For retirees on TRICARE Prime or TRICARE Select, this density of military families means that local providers are already accustomed to working within TRICARE's authorization framework. BrightStar Care of Frisco/Carrollton maintains Joint Commission accreditation — the same quality standard applied to military treatment facilities — which satisfies the quality benchmarks TRICARE and Humana Military expect from network home health agencies.

As retirees age into the 65-and-over bracket and transition to TRICARE For Life with Medicare, the coordination of benefits adds a layer of complexity. Our intake team understands the Medicare-primary, TFL-secondary billing sequence and ensures claims are filed correctly so you are not left with surprise out-of-pocket charges.

Active-Duty Family Coverage

Active-duty service members stationed at or traveling through the DFW metro area frequently need home health services for dependents rather than for themselves. A common scenario involves a spouse recovering from surgery while the service member is on TDY or deployed, or a child requiring pediatric home care following a hospitalization.

Under TRICARE Prime, active-duty family members (ADFMs) pay nothing out of pocket for authorized home health visits. Under TRICARE Select, ADFMs pay no cost-share for network providers after meeting the annual deductible. Either way, the financial barrier to home health care is minimal — the larger challenge is navigating the referral and authorization pipeline quickly enough to avoid gaps in care.

BrightStar Care of Frisco/Carrollton assigns a dedicated intake coordinator to every TRICARE case. That coordinator handles Humana Military communication, tracks authorization timelines, and keeps the family informed at every step. For families where the sponsor is deployed or otherwise unavailable, we work with the authorized family representative to keep the process moving.

Clinical Services Available Under TRICARE Home Health

TRICARE's home health benefit covers a broad range of clinical and supportive services when medically necessary and ordered by a physician. The following services are available through BrightStar Care of Frisco/Carrollton under TRICARE authorization:

• Skilled Nursing — wound care, IV infusion management, medication management, disease education, catheter care, ostomy care, diabetic management, post-surgical monitoring
• Physical Therapy — gait training, strength and balance programs, post-orthopedic rehabilitation, fall-prevention protocols
• Occupational Therapy — activities of daily living retraining, adaptive equipment assessment, energy conservation techniques, upper-extremity rehabilitation
• Speech-Language Pathology — swallowing therapy, cognitive-linguistic rehabilitation, voice therapy, aphasia treatment
• Medical Social Work — benefits coordination, community resource connection, caregiver support planning, discharge planning assistance
• Home Health Aide Services — bathing, grooming, dressing, ambulation, meal preparation, and light housekeeping performed under the supervision of a registered nurse

All clinical services are delivered by licensed, credentialed professionals. BrightStar Care of Frisco/Carrollton's Joint Commission accreditation means every clinician undergoes competency validation, background screening, and ongoing education — the same standards that govern care at military treatment facilities.

Chronic Disease Management at Home for TRICARE Beneficiaries

Post-surgical recovery is the most visible trigger for home health, but chronic disease management represents the growing core of TRICARE home health utilization in the Frisco–Carrollton corridor. Military retirees and their spouses face the same chronic conditions as the general aging population — diabetes, congestive heart failure, COPD, chronic wounds, and post-stroke deficits — and TRICARE covers the skilled nursing and therapy services required to manage these conditions at home rather than through repeated emergency department visits or hospital admissions.

A typical chronic-disease home health episode might include twice-weekly skilled nursing visits for medication reconciliation, blood-pressure monitoring, weight tracking, and symptom assessment, combined with physical therapy to maintain mobility and reduce fall risk. For diabetic beneficiaries, our nurses provide insulin administration oversight, blood-glucose log review, dietary counseling, and foot-care assessments. For heart failure patients, the focus shifts to daily weight monitoring, fluid-restriction education, recognition of decompensation signs, and coordinated communication with the cardiologist.

The value proposition is straightforward: every hospital readmission avoided saves the TRICARE system tens of thousands of dollars and spares the beneficiary days or weeks of disruption. BrightStar Care of Frisco/Carrollton's clinical team uses evidence-based chronic-care protocols that align with the quality measures Humana Military tracks for network providers.

TRICARE Home Health for Mental and Behavioral Health Conditions

TRICARE recognizes that mental and behavioral health conditions can require in-home clinical intervention. While traditional outpatient mental health care occurs in office settings, certain situations — a beneficiary recovering from a traumatic brain injury, a military spouse with severe postpartum depression who cannot safely travel with an infant, or a retiree with dementia-related behavioral symptoms — may qualify for home-based skilled services.

Home health nursing can support psychiatric medication compliance, assess cognitive and functional status, provide caregiver education on managing behavioral symptoms, and coordinate with the beneficiary's psychiatrist or psychologist. Occupational therapy can address cognitive rehabilitation for TBI survivors, and medical social work can connect families with community mental health resources in Frisco, Carrollton, Lewisville, and Addison.

Understanding TRICARE's Catastrophic Cap and Annual Deductibles

Every TRICARE plan includes financial guardrails that limit your annual out-of-pocket exposure. Understanding these limits helps you plan for home health costs with confidence.

The annual deductible is the amount you pay before TRICARE cost-sharing kicks in. For active-duty family members on Select, the deductible is $150 per individual or $300 per family. For retirees on Select, it is $150 per individual or $300 per family for E-5 and above (lower for E-4 and below). Prime beneficiaries have no annual deductible.

The catastrophic cap is the maximum amount a family pays out of pocket in a calendar year. Once you hit the cap, TRICARE pays 100% of covered charges for the remainder of the year. For active-duty families, the catastrophic cap is $1,000. For retiree families, it is $3,500. These caps include all out-of-pocket costs — not just home health, but all TRICARE-covered services combined.

For families facing extended home health episodes — such as a retiree recovering from a major stroke or a dependent child requiring months of skilled nursing — the catastrophic cap ensures that financial exposure is bounded regardless of how many visits are authorized.

Navigating TRICARE After a PCS Move to the DFW Metro Area

Permanent change of station (PCS) moves to the Dallas–Fort Worth metropolitan area bring thousands of military families through Frisco, Carrollton, The Colony, and surrounding suburbs every year. If you are arriving with an active home health authorization from your previous duty station, the transition requires careful coordination to avoid gaps in care.

TRICARE benefits travel with you — your plan does not change when you PCS within the same TRICARE region (East). However, you will need a new home health provider at your destination. BrightStar Care of Frisco/Carrollton can accept a transfer of your existing authorization or work with your new PCM to establish a fresh referral. Our intake team requests your clinical records from the previous provider to ensure continuity.

If you are PCSing from a TRICARE West Region installation, your plan transitions from Health Net Federal Services to Humana Military. We guide you through any re-authorization requirements that arise from the regional contractor change so that care resumes without delay.

TRICARE and the Extended Care Health Option (ECHO)

Families of active-duty service members who have a qualifying disability may be eligible for the Extended Care Health Option (ECHO). ECHO provides benefits beyond the standard TRICARE coverage, including extended home health aide hours, respite care, and assistive technology. If your dependent has a moderate or severe disability and you are exploring long-duration home health support in Frisco, Carrollton, Farmers Branch, or Coppell, ask our intake team about ECHO eligibility screening.

Wound Care and Infusion Therapy at Home Under TRICARE

Two of the most clinically intensive home health services — wound care and home infusion therapy — are fully covered under TRICARE when medically necessary. Understanding what each entails helps families prepare for what the home health experience actually looks like day to day.

Wound care encompasses everything from surgical-incision monitoring and suture or staple removal to complex wound management involving negative-pressure wound therapy (wound VAC), enzymatic debridement, compression therapy for venous ulcers, and offloading strategies for diabetic foot wounds. A BrightStar Care RN assesses the wound at each visit, measures dimensions, photographs the wound bed for documentation, selects appropriate dressings, and educates the patient and family on signs of infection or delayed healing. For TRICARE beneficiaries discharged from Baylor Scott & White Medical Center – Frisco or Medical City Lewisville after surgical procedures, wound care visits often begin within 24 hours of arriving home.

Home infusion therapy includes intravenous antibiotics for osteomyelitis or cellulitis, IV hydration for beneficiaries who cannot maintain oral intake, parenteral nutrition for patients with GI complications, and certain biologic or chemotherapy infusions approved for home administration. The RN establishes IV access (peripheral or manages existing central-line access), administers the infusion, monitors for adverse reactions, and flushes and maintains the line between infusions. Home infusion eliminates the need for daily trips to an infusion center — a significant quality-of-life improvement for beneficiaries in Frisco, Carrollton, and surrounding suburbs who would otherwise face a 30- to 60-minute drive each way to a clinic in Dallas.

Fall Prevention and Home Safety for TRICARE Beneficiaries

Falls are the leading cause of injury-related hospitalization among adults over 65 — a population that includes a substantial portion of TRICARE retirees. Home health physical and occupational therapists conduct comprehensive fall-risk assessments that include gait analysis, balance testing, medication review (many medications increase fall risk), footwear evaluation, and a home environment scan for tripping hazards, inadequate lighting, missing grab bars, and unsafe stairways.

Following the assessment, the therapy team implements an individualized fall-prevention plan that may include strength and balance exercises, gait training with or without assistive devices, recommendations for home modifications, and coordination with the physician regarding medication adjustments. For TRICARE beneficiaries in Highland Village, Corinth, or Lake Dallas who live in multi-level homes, stair-safety strategies and recommendations for stairlift installation become part of the conversation.

The financial impact of preventing even a single fall is substantial. A hip fracture — the most costly fall-related injury — typically involves surgery, a hospital stay of 3 to 7 days, inpatient rehabilitation, and months of outpatient therapy. TRICARE covers all of these services, but the human cost in pain, lost independence, and prolonged recovery far outweighs the financial dimension. Proactive fall prevention through home health therapy is one of the highest-value interventions TRICARE-authorized home health can deliver.

TRICARE and CHAMPVA — Different Programs, Different Rules

Another common point of confusion involves TRICARE and CHAMPVA. While both are federal health programs for military-connected families, they serve different populations. TRICARE covers active-duty, Guard/Reserve, and retirees and their families. CHAMPVA covers dependents and survivors of veterans with permanent, total service-connected disabilities. The two programs have separate eligibility rules, separate claims systems, and separate authorization procedures. If you are unsure which program applies, contact TRICARE at 1-800-444-5445 or the CHAMPVA Center at 1-800-733-8387.

How BrightStar Care of Frisco/Carrollton Supports TRICARE Beneficiaries

We built our TRICARE intake workflow around one principle: the family should not have to become a benefits expert to get care started. Here is what that looks like in practice:

• Eligibility verification — we check your DEERS enrollment and TRICARE plan status before the first visit
• Authorization management — we submit and track prior authorizations with Humana Military, including re-authorization requests
• Claims filing — we bill Humana Military directly; you pay only your plan-specific copay or cost-share
• Plan-of-care coordination — we communicate with your PCM, specialist, or MTF provider to keep orders current
• Quality reporting — our Joint Commission accreditation means we meet the quality metrics TRICARE network participation requires

Whether you are a retiree in Hebron managing a chronic wound, a military spouse in The Colony recovering from knee replacement, or a Guard member's family in Lake Dallas navigating a complex pediatric case, the process follows the same streamlined pathway.

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Frequently Asked Questions About TRICARE Home Health Care in Frisco and Carrollton

Does TRICARE cover home health care in Texas?

Yes. TRICARE covers medically necessary home health care in all 50 states, including Texas. Because Texas falls in the TRICARE East Region, Humana Military is the managed-care support contractor that processes authorizations and claims for home health services in Frisco, Carrollton, and surrounding communities.

Do I need a referral to start TRICARE home health care?

It depends on your plan. TRICARE Prime requires a referral from your primary-care manager before home health services can be authorized. TRICARE Select, TRICARE For Life, and TRICARE Reserve Select do not require a referral — you can contact a TRICARE-authorized home health agency directly after obtaining a physician's order.

What is the difference between TRICARE and VA health care?

TRICARE is the Department of Defense health-care program covering active-duty members, their families, retirees, and certain Reserve/Guard members. VA health care is administered by the Department of Veterans Affairs and covers eligible veterans. A military retiree may carry both TRICARE and VA eligibility simultaneously, but the two programs have separate enrollment, separate providers, and separate claims systems.

How much does TRICARE home health care cost out of pocket?

Active-duty service members pay nothing. Active-duty family members enrolled in Prime pay nothing for network home health visits. Retirees enrolled in Prime pay approximately $12 per network visit. Select retirees pay a 20% cost-share after meeting their annual deductible. TRICARE For Life beneficiaries typically pay $0 after Medicare covers its portion. All beneficiaries are protected by an annual catastrophic cap.

What services does TRICARE home health cover?

Covered services include skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social work, and home health aide services when ordered by a physician and deemed medically necessary. The specific scope and duration of services are determined by the authorization from Humana Military.

Is BrightStar Care of Frisco/Carrollton in the TRICARE network?

BrightStar Care of Frisco/Carrollton maintains Joint Commission accreditation and works within the TRICARE network framework administered by Humana Military. Contact our intake team at 214-396-1505 to verify network status for your specific plan and service needs.

Can TRICARE home health care start on the same day I leave the hospital?

In many cases, yes. Hospital discharge planners at Baylor Scott & White Medical Center – Frisco, Medical City Frisco, Medical City Lewisville, and other area hospitals can initiate the home health referral before you leave the facility. When the authorization is obtained same-day or the following business day, our RN assessment can be scheduled immediately.

Does TRICARE cover home health for children?

Yes. Dependent children covered under a sponsor's TRICARE plan are eligible for medically necessary home health services. Pediatric skilled nursing, therapy services, and home health aide support are covered when ordered by the child's physician and authorized through Humana Military.

What is TRICARE's Extended Care Health Option (ECHO)?

ECHO is a supplemental benefit available to dependents of active-duty service members who have a qualifying physical or psychological disability. ECHO can provide extended home health aide hours, respite care, and other benefits beyond the standard TRICARE coverage. Enrollment in the ECHO program requires registration through the TRICARE ECHO office.

Can I use TRICARE and CHAMPVA at the same time?

No. TRICARE and CHAMPVA eligibility are mutually exclusive. If you are eligible for TRICARE, you cannot enroll in CHAMPVA. CHAMPVA is reserved for dependents and survivors of veterans with permanent, total service-connected disabilities who are not otherwise eligible for TRICARE.

How long does TRICARE authorization take for home health?

Standard authorization through Humana Military typically takes 3 to 5 business days. Urgent or expedited authorizations — such as those associated with a hospital discharge — can often be processed within 24 to 72 hours. Our intake team monitors every authorization request and escalates delays proactively.

What happens if my TRICARE home health authorization expires before I finish treatment?

If your clinical team determines that additional visits are medically necessary beyond the initial authorization period, BrightStar Care of Frisco/Carrollton submits a re-authorization request to Humana Military on your behalf. The re-authorization includes updated clinical documentation from your physician to support the continued medical necessity.

Does TRICARE For Life cover home health the same as regular TRICARE?

TRICARE For Life beneficiaries receive home health coverage through a Medicare-primary, TFL-secondary payment structure. Medicare's home health benefit covers the initial costs, and TFL picks up qualifying remaining balances. In most cases, TFL beneficiaries pay $0 out of pocket for covered home health services.

Which areas near Frisco and Carrollton does BrightStar Care serve for TRICARE home health?

BrightStar Care of Frisco/Carrollton provides TRICARE home health services throughout Frisco, Carrollton, The Colony, Little Elm, Lewisville, Highland Village, Hebron, Corinth, Lake Dallas, Addison, Farmers Branch, and Coppell, as well as surrounding areas in Denton County and northwest Dallas County.

How do I verify my TRICARE eligibility for home health care?

You can verify your TRICARE eligibility by logging into the milConnect portal, contacting Humana Military at 1-800-444-5445, or calling our intake team at 214-396-1505. We verify DEERS enrollment and plan status as part of every intake.

Related Resources

• Veterans Home Care in Frisco and Carrollton, TX
• CHAMPVA Home Health Care in Frisco and Carrollton, TX
• Skilled Nursing Care at Home in Frisco and Carrollton, TX
• Hospital-to-Home Transitional Care in Frisco and Carrollton, TX
• Pediatric Home Care in Frisco and Carrollton, TX

Disclaimer: The information on this page is provided for general educational purposes only and should not be considered legal, medical, or benefits advice. TRICARE plans, eligibility criteria, covered services, and cost-sharing structures are subject to change without notice. BrightStar Care of Frisco/Carrollton makes no representations or warranties — express or implied — regarding the accuracy, completeness, or timeliness of the information presented here. We accept no liability for any decisions made or actions taken based on this content. Always verify your eligibility and covered benefits directly with TRICARE (1-800-444-5445) or your regional contractor before making care decisions. This page does not create a provider-patient relationship.

Schedule Your Free RN Assessment Today

Call or text 214-396-1505 for a live answer — no phone tree, no hold queue, no voicemail runaround. You'll leave the first call with a clear plan of care.

• Never wait on hold — a real person picks up every call
• Never press a prompt — no automated phone tree
• Plan of care on the first call — our RN starts building your care plan immediately

Prefer to reach us another way? Fax: (972) 379-0555 | Online: Submit a request through our contact form