Access or Remove Personal Information

Please complete this form to submit a request related to your information.

Requests are subject to identity verification.

For more details on how we collect and use personal information, please visit our Privacy Policy page at https://www.dhccare.com/privacy-policy

Request Type

First Name

Last Name

Billing Street Address

Billing Street Address 2

City

State

ZIP Code

Phone

Customer Number (if known)

Shown in the left corner in a blue shaded box on the back of your catalog or on the packing slip.

User Type

I consent to the access or removal of my personal information.