Fox Valley Psychiatry located at 4321 W College Ave, Ste 200, Appleton, WI 54914

Patient Forms & Policies

Download the form. Fill it out. Then send a message to Dr. Rueff in the Tebra patient portal with the form as an attachment.

Login to Portal

If you do not have a portal account you can fax forms back to: 920-214-1187, drop them off at the office, or mail them back to Fox Valley Psychiatry Attn: Medical Records 4321 W College Ave, Ste 200, Appleton, WI 54914

Policies and Procedures
Notice of Privacy Practices
Privacy Practices Consent Form
Request for Restriction of PHI
Request to Amend PHI
Release of Information Authorization
Authorization to leave message on phone
Accounting of Disclosures
Financial Agreement
No Surprises Act Factsheet