Patients or their representatives can complete and submit an Authorization to Release their medical records.
Legally authorized representatives include the parent of a minor child, a health care agent/proxy when the patient is medically determined to lack capacity, a distributee (the person with a certified copy of a deceased patient’s death certificate).
Can I still do the paper form?
The paper form can be submitted.
Where do I send the completed form if the request is a paper request?
Stony Brook University Hospital
Health Information Management Department
500 Commack Road, Suite 171
Commack, NY 11725
OR
FAX # 631-444-7738
Can parents request copies of the medical record for their minor child?
Parents for the patients under the age of 13 may request their child’s medical records.
Is there a number I can call if I need help with completing the form or to check the status of a request I submitted?
Yes, please call 631-444-1300 for further assistance.