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MyDCH Access Forms

MyDCH Access Forms

Patient Portal Access Form

Patient Portal Proxy Access Form

The completed forms and copies of the required ID can be brought to the Medical Records/Healthcare Management department at any DCH hospital, or sent via


U.S. Mail:
Release of Information
DCH Health System
809 University Blvd. E.
Tuscaloosa, AL 35401

For more information about MyDCH, click here.