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How To Order SpinalQ

Documents Needed to Order the AlignMed SpinalQ Brace :

 

1. Letter of Medical Necessity/Script:  

Download form.
Please include height, weight, waist, and chest measurements.

 

2. Demographics/Face Sheet:

Patient's address, phone #, and date o birth.

 

3. Insurance Card:

Copy of the front and back of insurance card.

 

4. Chart Notes from your Doctor:

To back up your prescription.

 

5. RFA :

Work comp only.

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