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HEBE ESTRELLA-SCHULTZ MD Diplomate of the American Board

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The document is an application for service and consent for treatment of minors by Dr. Hebe Estrella-Schultz, a psychiatrist. It outlines the consent of a parent or guardian for their child to receive evaluation and treatment, including financial responsibilities related to insurance and service fees. The document also includes assessments for behavioral and emotional issues in children, such as the NICHQ Vanderbilt Assessment Scale and the Screen for Child Anxiety Related Disorders (SCARED), along with a mood disorder questionnaire. Confidentiality of records and conditions under which information may be disclosed are also addressed.

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