Professional Sample Request Form for DEKAs Plus Products
Note that we can only ship samples to CF Centers, Bariatric Centers, Hospitals, and Specialty Clinics and Physician Offices.
Please indicate below which products you would like to receive.
Thank You for your consideration of Callion Pharma products.
If the form does not work, please email email@example.com with your information.
Customer Service: 423-930-9243