Carole J. Jacobson, MS, LMFT

Before the first session it would be helpful for you to print off, read and fill out the following forms  that pertain to your issues.  Please bring the forms  to your  first appointment with me.

  • Client Information Form (pdf)
  • Release of Information Form (pdf)
  • Couple Questionnaire Form (pdf)
  • Disclosure Statement / Informed Consent Form (pdf)

Note: All of the forms are in Adobe Acrobat PDF format.  If you do not have Adobe Reader on your computer, you can click the below button to download and install it.

If you have any problems opening the forms, you can try to save them to your local computer by right-clicking on the pdf link and choosing Save As (Windows only).  If you do not have the latest version of Acrobat Reader, you may want to upgrade the version on your computer.

Carole J. Jacobson, MS, LMFT
600 Main Street, Suite D,  Edmonds,  Washington 98020
(425) 771-6356