CONSULTATION APPLICATION
Thank you for your interest in working with Courtney Shrum at Candor. 

Candor specializes in working with somatic body based approaches to better understand your mental health in an individual online setting. This application helps to see if there is a "goodness of fit" for services based on what you submit.

Please fill out the following application to schedule your consultation. 
Please expect a reply within 48 hours of submitting your application. 

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Name *
First and last name.
Email *
How you will be contacted about your application.
Location *
Candor services are Online/Telehealth only. No in person sessions are currently offered.

Please note if you are only seeking psychotherapy/counseling services you will need to be located within the state of Washington.
Age *
Candor provides services for individual adults (18+).
briefly describe why you are seeking counseling at this time *
Please note that Candor does not specialize in working with clients who are experiencing active suicidal ideation or an active diagnosable eating disorder. These situations demand a higher level of care than a private practice setting can offer. If you are experiencing active suicidal ideation or an active diagnosable eating disorder please use PsychologyToday.com to seek a provider who specializes in the appropriate level of care for you.
Current Symptoms *
Required
Current Availability *
Hours for Candor are as follows, please note that scheduling is based on current availability: 
Tuesday 9:00am -12:00pm & 1:00pm - 4:00pm
Wednesday 9:00am -12:00pm & 1:00pm - 4:00pm
Thursday 9:00am -12:00pm & 1:00pm - 4:00pm
Friday 9:00am -1:00pm

Please select the current times that work best with your schedule:
Required
Consultation preference *
Frequency of sessions *
How often would you ideally like to be seen?
How did you find Candor?
I have reviewed the payment terms and agree that the payment listed ($165 self-pay or sliding scale) is feasible for me.
 *
Payment Terms: Sessions are billed at $165 per client hour (~50 mins). These sessions can be submitted through your insurance provider for potential reimbursement as an out of network (OON) service (note: not all insurance providers will provide reimbursement). Reimbursement rates may vary. 

Full payment is required at time of service and will be auto-billed to a card on file. 
Click here if you would like to check your OON insurance benefits for working with Courtney.
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