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welcome stony brook southampton hospital has partnered with verissima a national leader in records management to offer you an online way to request copies of your medical record to access the hospitals verisima online medical record request form go to our home page at southampton.stonybrookmedicine.edu click on patient and visitors tab along the top banner click on how to request medical records scroll to the red button and click here for online medical records select patient request form or patient representative if you are a patient requesting your own medical records select patient request form if you are not requesting your own records but rather someone elses and you have the authority to do so select representative request form for the purpose of the rest of this video we will be selecting patient request form you will now be directed to the online authorization for release of medical information form here you will need to provide specific information within the response boxes