Your Medical Records

Phone: (631) 726-8310
Fax: (631) 702-8061

Requesting Your Medical Records and/or Radiology Images

You may request release of your confidential medical information for your own use, or request records be sent to your physician or other representative. When requesting your confidential medical information, please complete all areas of the Authorization for Disclosure of Health Information form to avoid delays in processing your request.

Download form

You may mail or hand-deliver your completed authorization to:

STONY BROOK SOUTHAMPTON HOSPITAL
RELEASE OF INFORMATION MANAGEMENT ROOM 110
240 MEETING HOUSE LANE
SOUTHAMPTON, NY 11968

The Release of Information Division is open Monday through Friday from 8:00 A.M. to 5:00 P.M.

  • There is no charge to you for your medical records if we send them to another health care provider.
  • If you are requesting records for your personal use, request only records that you need such as a specific date of service or related to a specific injury.

In some cases, Instead of a full copy of your record a less expensive abstract of your medical record may be sufficient. The abstract contains the following:

Face Sheet Laboratory Reports

Discharge Sumary

Radiology Reports (X-rays, CT, MRI, etc.)

Admission History/
Physical

EKG/EEG Reports

Consulations

Cardiac Testing (Holter, Echo, Stress, etc.)

Operative Reports

Special Procedures (endoscopy, colonoscopy, etc.)

Pathology Reports

Emergency Room Reports

If you are requesting records for yourself or your legal representative, please be aware that there is a fee of $0.75 per page, plus shipping for paper copies. If you request a full copy of your record, you will be billed for every page, which could result in substantial charges.

If you are requesting copies of radiology images please complete the Patient Request form fax the completed form to (631) 702-8061 or mail it to:

STONY BROOK SOUTHAMPTON HOSPITAL
RELEASE OF INFORMATION MANAGEMENT ROOM 110
240 MEETING HOUSE LANE
SOUTHAMPTON, NY 11968

The Patient Portal

Southampton Hospital offers patients the opportunity to take charge of their health via the Patient Portal. This is a convenient, secure, online tool available 24/7 that will help you view, download, or transmit your health record. To sign up, please ask for details when you are being admitted to Stony Brook Southampton Hospital. Learn more.

NY Care Information Gateway

NY Care Information Gateway is a Regional Health Information Organization (RHIO), which is made up of hospitals, doctors, and other healthcare providers. The RHIO allows healthcare providers to use secure computer networks to share information about their patients in an effort to provide better healthcare.

By signing up for the NY Care Information Gateway, you can help providers to improve your care, save time in an emergency, create quick access to your test results, ensure that your privacy is protected, and reduce the need for paper copies of your health records. 

To sign up, you must complete a consent form, available in the Patient Access department on the first floor near the main lobby. Please ask our staff for details when you visit the Hospital or call (631) 726-8380.

Birth Certificates

To obtain a birth certificate for a person born at Stony Brook Southampton Hospital, please contact the Southampton Village Clerk's office at (631) 283-0247.