Welcome to Health Information Management, where you can conveniently access medical records and submit information requests.
Hours: Monday through Friday from 7 am to 4 pm.
Stony Brook Eastern Long Island Hospital
Attn: Health Information Management
201 Manor Place
Greenport, NY 11944
(631) 477-5232 | Fax (631) 477-8316
For Radiology Images please call (631) 477-5137.
Medical Records 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 the Patient
I am the Patient Representative
I am an Attorney
Please note: subpoenas are not accepted
with this method.
Accessing Medical Records
Patients who were seen at Stony Brook Eastern Long Island Hospital 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.
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 Health Information Management Department at (631) 477-5232 or (631) 477-5436. Please note a certified copy of the death certificate will be required to verify that the patient is deceased.
If the patient is incapacitated, unable to sign for themselves 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.
Additional Requests
- Patient Request to Amend their Health Information
- Patient Request for an Accounting of Disclosures
- Requested Use or Disclosure of Protected Health Information Potentially Related to Reproductive Health Care Attestation, only for the following requests:
- To a health oversight agency for a health oversight activity
- To a law enforcement official for a law enforcement purpose
- For judicial and administrative proceedings
- To a coroner, medical examiner or funeral director for duties authorized by law