Medical Record Request

The Long Island State Veterans Home (LISVH) protects the confidentiality of every resident’s or registrant’s medical records. As a resident or registrant, you have the right to access your medical records.

To contact the LISVH Medical Records Department by phone: Phone numbers: 631-444-8734 or 631-444-8735

Residents, registrants, and/or their legal representatives may complete the authorization form below and submit it using one of the following methods:

Submission Methods

In person: Drop the form off at the Medical Records Office at the Long Island State Veterans Home.

By fax: 631-444-8738

By mail:
Long Island State Veterans Home
Medical Records Department
100 Patriots Road
Stony Brook, NY 11790

Special Circumstances

If the resident or registrant is deceased, please contact the Medical Records Office at 631-444-8734 or 631-444-8735. A certified copy of the death certificate will be required for verification.

Forms