Policies & Forms

Dr. Sherri Broadwater is committed to providing you with comprehensive, emotional wellness care in a warm and innovative healing space.  Reviewing the policy information below will assist you in obtaining optimal care from Dr. Broadwater.

APPOINTMENT SCHEDULING 

Please complete all forms before your appointment. The goal of the appointment is to focus on hearing your story and understanding your journey. Please call the office at 404-458-0382 to schedule an appointment.  Please complete the intake forms (See the attached links) before your initial evaluation. Dr. Broadwater sees patients primarily on W, Th, and Fridays between 11-7 pm but this may vary.  The last appointment is at 6 pm. If your preferred appointment time is not available, feel free to call the office and let me know so I can better assist you.

REFERRALS

A referral may be needed based on your insurance agreement. Call the behavioral health phone number on the back of your card to find out if this is necessary. The referral is needed before an appointment is scheduled.

PHONE CALLS

Phone calls are returned between 2:00-3:00 pm and between 2:00-and 7:30 pm primarily on T, Th, and F.

PARKING

There is free, street parking directly in front of the office double doors which face Cherokee Avenue. 

PORTAL

Questionnaires will be sent through the Luminello Electronic Medical Record portal.  

PAYMENT

We accept Paypal, check and cash.  Invoices and receipts of payment are either emailed or mailed monthly or on request. Full payment must be received before a new patient appointment is scheduled.

CANCELLATIONS

All appointments cancelled or rescheduled within 48 hours of the scheduled time will be charged partial or full fee. 

PRIVACY

Your information will not be discussed or shared with anyone or any institution without your permission.

MANDATED REPORTING 

As a mandated reporter, I must report suspicious child, elderly abuse and maltreatment to the authorities. I will take action to keep you and others safe in the face of threats of harm to self or others.

TREATMENT TERMINATION 

Although you may end treatment at any time, I firmly recommend that you share your desire to end treatment and process this decision in at least one final face to face meeting, rather than terminating by phone or mail. If for any reason, I have to terminate my relationship with you as your doctor, I will extend the same courtesy of having a discussion with you. I will make sure you have a 1-month supply of non-controlled medication. I will also provide you with a list of resources to find another psychiatrist that may be better suited for you and your level of complexity.

EMERGENCIES

If you have an urgent or emergent concern, you can call Dr. Sherri Broadwater’s office and leave a message.  Dr. Sherri is available unless otherwise indicated though she may call you back after leaving a message.  

Mental health emergency services are available through 911, Georgia Crisis Access line 1-800-715-4225 and the Suicide prevention line 1-800-273-8255. The National Domestic Violence Hotline is 1-800-799-7233.

Thank you for taking the time to review these policies. I look forward to working with you.


Best Regards,

Dr. Sherri Broadwater  

NEW PATIENT FORMS 

Thank you for taking time from your busy schedule to download our New Patient Forms. A LEGIBLE copy of the responsible party’s Driver’s License (or other VALID form of Government Issued Identification) and a copy of the insurance card is required. 

CHILD NEW PATIENT

1) Pre-Intake Fillable Form 

2) Office Policies 

3) Financial Agreement – (Insurance)

4) Financial Agreement – (Self Pay or Concierge)

5) Release of Authorization Form 

6) HIPPA Form 

7) Minor Consent Form 

8)Psychosocial questionnaire   

ADULT NEW PATIENT

1) Pre-Intake Fillable Form 

2) Office Policies 

3) Financial Agreement – (Insurance or Worker’s       Compensation)

4) Financial Agreement – (Self Pay or Concierge)

5) Release of Authorization Form 

6) HIPPA Form

Please download the forms and complete before your appointment. Please bring completed forms to your new patient appointment.

Contact Dr. Sherri at info@healingforall.net and
404-458-0382.