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 Eastern Long Island Hospital
Attn: Health Information Management
201 Manor Place
Greenport, NY 11944
OR
FAX # (631) 477-8316
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) 477-5232 for further assistance.
