Before you come to your appointment at Riley Hospital for Children Child & Adolescent Psychiatry at Indiana University Health, please download and fill out this form.
It is designed to allow you to fill out the form on your computer then print out the completed form. You can also print out the form and fill it out in writing if you prefer.
Be sure to bring this completed form with you to your appointment.
To refer a patient to Riley Child & Adolescent Psychiatry at IU Health, please download and fill out this form.
Fax the completed form to 317-274-0609.
You can also mail the completed form to:
Child & Adolescent Psychiatry
705 Riley Hospital Drive
Indianapolis, Ind. 46202