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 of 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.


Click HERE for a free no obligation insurance verification to determine if your insurance will cover the SpinalQ brace, if so follow the steps above once you hear from our insurance specialist.