Riley Pediatric Cardiology
4.8 out of 5 stars
Score is an average of all responses to care provider related questions on our nationally-recognized NRC Health Patient Experience Survey.Learn About Survey
Riley Physicians South Bend
621 Memorial Drive, Suite 612
South Bend, IN 46601
Reopens on Monday 8:00 AM
Doctors At This Location
Forms & Resources
Please complete for the first visit.
Authorization to Release Medical Records
Complete this form when you’d like for medical records to be released to another entity.
You will be asked to review and sign this consent to receive care from our physicians and staff.
Complete this form to allow family and friends to receive information regarding your health.
What to Bring
- Your child’s current insurance information
- Form of identification
- List of all medications your child is currently taking, including how many times per day and the dose (be sure to include both prescription and over-the-counter medications)
- List of questions or concerns for your child’s doctor
- Medical records (e.g. X-rays, lab test results, etc.)—your referring physician may have already sent these records, so be sure to ask your doctor before your child’s visit with us
- Form of payment for any deductible and/or co-insurance required by your insurance plan