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Downloadable Forms

The following forms are used to request accounts for access to the various applications and resources administered by the Stony Brook Medicine Information Services division.

Computer Account Request Form:

This form is used to request accounts for the following: Network Accounts (UHMC), SMS/UHIS, RAS, Eclipsys, Lawson, Radiology / Cardiology, Microsoft Outlook, MUSE and Cerner (PowerChart, SurgiNet, EWS or PharmNet)


The Information Security Office has granted certain designated users access to the following online account maintenance form:

Cerner DIRECT Secure Messaging Request:

DIRECT messaging is a method of secure messaging between external providers and internal Stony Brook Medicine providers via Message Center in the STARS Cerner PowerChart System.

Request tickets should be assigned to the Cerner PowerChart Application Specialist group with the spreadsheet below attached to the ticket. The requestor should fill out and send us the form.

Cerner DIRECT Secure Messaging Request

***See Also: Cerner DIRECT Secure Messaging FAQs

Cerner Printer Form:

Please note that if you would like to print from the Cerner suite of applications, you will need to complete a Request for Cerner Printer form via the Help Desk Self Service Portal so that the printer can be defined to the Cerner applications.

Cerner Printer Form Instructions


Crystal Reports Request:

Crystal Reports provides staff access to reports created by IT and others against a variety of applications (Cerner, Eclipsys, Kronos, Lawson). Security is enabled to ensure that staff can only view reports for which they are authorized. Customers requesting access to a folder or Crystal Report, are required to have authorization from their supervisor via email to the Crystal Administrator at:

The Crystal Enterprise User ID and Password Form has been discontinued.

All Crystal Report requests must be submitted through our Help Desk Self-Service Portal:


Remote Access Forms:

For Employees/Staff:

For Vendors – Non-SBUH Employees:

Stony Brook Medicine Community Doctors Form:

Stony Brook Medicine Community Doctors.pdf

STARS / Cerner Requests:

Effective immediately all requests for changes or enhancements to the electronic record ONLY STARS / Cerner Requests System. Please use the Data/Reports link to request any other data. A STARS / Cerner Request can be submitted from the Stony Brook Medicine Intranet Portal website, under My Requests:

STARS / Cerner Request System

Report/Data Requests:

Effective immediately all requests for new reports or changes to existing reports from the following systems: RC9U, Crystal and RAS must be submitted through the newly created Report/Data Requests System. A Report/Data Request can be submitted from the Stony Brook Medicine Intranet Portal website, under My Requests:

Report/Data Request System

You will need Adobe Acrobat Reader to view or print these forms.

Phone: 631-444-HELP         Fax: 631-706-4539