Your Medical Records

WELCOME TO HEALTH INFORMATION MANAGEMENT

We are dedicated to ensuring the integrity and security of your private health information in accordance with state and federal regulations.

Health records are retained for a period of 21 years after your last date of service or final treatment. Patients have the right to review their health record, for information please call (631) 726-8310. Some fees may apply. However there is no fee when the records are sent directly to a healthcare provider for the purposes on continuity of care. 

Many of Stony Brook Southampton Hospital Medical Records can be accessed and reviewed online 24/7 in the PATIENT PORTAL. Please click to the  visit the Patient Portal  https://southampton.stonybrookmedicine.edu/patients-visitors/patient-portal

For information on how to create your personal Patient Portal account, contact: (631) 726-8310.

REQUESTING COPIES OF MEDICAL RECORDS FROM STONY BROOK SOUTHAMPTON HOSPITAL

How To Safely and Securely Request Your Medial Records online

Click to View our How To Video

For the convenience of our patients and/or their legal guardian, you can request and receive copies of your medical records online. The online option often provides for faster turnaround of your request as it eliminates the delays caused by traditional mail. You can indicate if you wish to receive a secured link to download the medical records from Verisma, the Hospital’s secure 3rd party copy service vendor, or you select to have a CD or a paper copy sent via U.S. Mail Service. Please note that radiology and cardiology images can be requested online and will be sent via Mail as electronic delivery is not available at this time. In order to request your medical records online you must:

  • Be 18 years or older
  • Have a smartphone with a camera and texting capability
  • Have a valid driver’s license or other official government issued picture ID to request medical records online.
  • Legal guardians or healthcare proxies will need to upload a PDF or TIF copy of court appointed guardianship papers, power of attorney or other appropriate legal documents that can establish proof of guardianship.
  • Next of kin requesting copies of a deceased patient’s medical record will need to upload a PDF or TIF copy of the official death certificate. Next of kin begins with the surviving spouse. If there is no spouse, the request can be made by an adult member of the deceased patient’s immediate family. You must also complete and upload an Affidavit Of Distributee form.


All online requests will be processed within 3 to 5 business days of receipt of the request

 

If you do not wish to request medical records online, please select the appropriate form below and click to print:

Click here to print the Patient Request for Disclosure of Medical Records Form

Click here to print the Authorization for Disclosure of Health Information Form

Click here for Affidavit of Distributee Form

 

To hand deliver or mail your request form along with a copy of valid ID, please use the following address:

Stony Brook Southampton Hospital
Health Information Management Department
240 Meeting House Lane
Southampton, New York 11968

Hours of Operation: Monday - Friday 8:00am to 4:30pm

Email:   tracy.derrico@Stonybrookmedicine.edu

Fax:  631.702.8061

Please note that standard mail may take 10 business days to receive after being posted.

 

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.