SUNY Downstate Medical Center
Downstate Depot – Central Stores
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| Phone: | 718-270-1514 |
| Fax: | 718-270-1266 |
| MailStop: | 61 |
| Email: | Reception Desk |
| Location: | UH B-526. Enter thru Downstate Depot Reception UH B-530A; opposite Medical Records. |
| Hours: | M-F 9am to 5pm. Your order must be received by 4:45 pm in order to be processed by 5pm. |
| Asst Director: | Vacant, Kevin LeDoux retired 12/31/17 |
| Deputy Director: | Victor Haynes 718-270-3074 |
UHB Forms
To order, use Customized UHB Nursing Station & Clinical Labs CStores Order Form
UHB (Medical Record) FORMS in STOCK
The following UHB Health Information Management (HIM aka Medical Records) Forms are reproduced in the Quick Copy Center, and distributed to UHB units via Central Stores.
Click on the Form # to view the actual form - to confirm that is the Form you need.
SD014L Interdisciplinary Patient/Family Education Record (Sorry, not yet available-awaiting Med Records Director to provide clean crisp original)
SD015A Problem List Interdisciplinary Plan of Care
SD015B Interdisciplinary Plan of Care
SD015C Problem List Interdisciplinary Plan of Care
SD015D Problem List Interdisciplinary Plan of Care Continuation Page
SD061C Dept. Internal Medicine Progress Notes
SD075 Adult Risk/Fall Assessment Tool
SD0085 Acknowledgement of Photo/Video Rule in Delivery Room
SD149 Universal Protocol Checklist
SD212 Diabetic Record (Sorry, not yet available, awaiting Med Records Director to provide clean crisp original)
SD215 Advance Directive Status Form
SD314 Nursing Referral Fax Form
SD336 Authorization for Photo/Video of Patient
SD339 Consent to Surgery or Procedure
All other forms must be sent to State Purchasing with a Requisition for processing