Intake Forms

After you have scheduled your first appointment for gambling treatment with Kathryn Elliott-Hudson, you will need to complete intake paperwork. Print and fill out the set of forms that applies to your situation. Bring this intake paperwork with you to your first appointment that you have scheduled at Kathryn’s Mesa-Chandler office.

Gambling Intake Treatment Forms

Click on the appropriate set of intake forms. You will then be able to print them and fill them out prior to your first appointment:

Problem Gambler Intake Form

Affected Individual/Family Member Intake Form