Patients Are Able To Self Refer
Patients can establish with Fox Valley Psychiatry by visiting our Establish Care page.
- The patient clicks a button to schedule an initial appointment.
- In days their appointment is confirmed and an email is sent to them with a link to complete intake paperwork on a secure webpage.
Alternatively, if a patient refuses to have a link sent to their email address, they can complete an intake Health History Form. Print it out and drop it off or mail it back to our office. If your client wants a paper form to fill out and is in your office you can download and print the form (below).
To send patient records for a client already accepted, fax them to: 920-214-1187.
If you would like to discuss whether a client is appropriate for referral call 920-882-7780.
To receive a client’s progress notes or other Fox Valley Psychiatry records, fax a letter to 920-214-1187 stating the records being requested, the purpose of the request and in what capacity do you provide care to the client. The provider requesting records must also sign and fax the privacy agreement below with his/her request. Fox Valley Psychiatry respects client’s privacy. Clients are promised that their HIPAA protected mental health information will not be shared with anyone other than a healthcare provider who is using the information for direct patient care.
Patient Exclusions
NOT accepting Medicare clients. Will accept Medicaid.
Diagnoses not treated:
- Severe developmental disabilities
- Aggressive clients
- Substance abuse treatment
Unfortunately, people with the diagnoses above are not able to be seen at the clinic. This is due to the office setting limitations. The clinic is located within a shared office building that has other businesses in it and limited front desk staff. Appropriate care and safety for some clients cannot be provided in the waiting room with these limitations.