Medical Record Request

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.

I am an Attorney

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.

Hospital Records

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.

I am an Attorney

Please note: subpoenas are not accepted
with this method.

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?
View Instructions

How do I obtain copies of my medical records?
View Instructions

Special Circumstances

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.

Distributee Statement

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.

Additional Requests:

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