Legal

Disclaimer

Celly Health is not an insurance product or a prescription fulfillment warehouse.

Medical services rendered by your physician are subject to their professional judgment.

Celly Health operates subject to state regulation and may not be available in certain states.

Celly Health does not guarantee that a prescription will be written.

Celly Health physicians reserve the right to deny care for potential misuse of services.

Celly Health cannot guarantee your health insurance carrier will cover a part or all of your care services.

Email: legal@cellyhealth.com

Phone: 1-844-CELLYMD (844-235-5963)

International Patient

International Patient Intake

Complete the form below to begin your care. Fields marked * are required.

First Name *

Last Name *

Marital Status *

Date of Birth *

Sex *

Email *

Address 1 *

Address 2

City *

State *

Zip *

Work Phone

Ext.

Cell Phone

Home Phone *