If you would like to submit a medical record request online, please click on the following link(s) below.
Please note that different forms are used if you are the patient or if you are a patient representative making the request.
All requests will be processed within ten (10) business days of receipt of the requests.
Please note: subpoenas are not accepted
with this method.
Accessing Medical Records
Patients that were seen at Stony Brook University Hospital and/or Physician Practices can also access their medical records through our patient portal.
The patient has the right to receive a copy of their medical record or it can be provided in an electronic form.
If you are requesting that your records be sent to you via download, you will need to verify your email address before the records can be downloaded. Please expect an email from Verisma Customer Service and make sure to click on the link to verify. Please check your junk or spam folder as the email may not be recognized.
Alternatively, patients can complete the authorization form (below) in full and send it to the appropriate address provided on the form.
Physician Practice Records
To request a copy of your medical records from a physician who treated you, contact the physician’s practice office directly.
Request for Access to Health Information by Patient or Personal Representative for SBM Physician Practices
Third Party Requestors:
For disclosures when your medical records contain information for one or more of the following categories the patient or authorized representative is required to indicate this by initialing the appropriate section of the Authorization in addition to completing it in full:
- Alcohol/Drug Treatment
- Mental Health Treatment (except psychotherapy notes)
- HIV/AIDS Related Information
Frequently Asked Questions
How do I complete the Release of Information form?
How do I obtain copies of my medical records?
If the patient is deceased, please contact the Information Access Unit at 631-444-3709 or 631-444-1300. Please note a certified copy of the death certificate will be required to verify that patient is deceased.
If the patient is incapacitated, unable to sign for him or herself and there is a personal representative who is legally responsible then that individual will sign on behalf of the patient.
If the patient is a minor under thirteen (13), we will request that the minor child as well as the parent or legal guardian sign the authorization form.
For Radiology Images please click the below link.
- Patient Request to Amend their Health Information
- Patient Request for an Accounting of Disclosures
- Patient Request to Restrict their Health Information
- Patient Request to Discuss Their Patient Health Information w/ a Designee
- Patient Request for SBUH and SBM Physician Practices to Receive Health Information English
- Solicitud del paciente para SBUH y SBM Prácticas médicas para recibir información de salud Español