Let's Talk

Existing Patients

Please use the online scheduler below or access

your patient portal to schedule.

New Patients

Please fill out the form below and I will get back to

you with next steps.

Name

Gender

Email

Date of Birth

Pronouns

Phone

What is the main reason you are seeking treatment?

Please check any of the following that apply to you:

In therapy now

In therapy in the past

In hospital (or IOP) now

Hospitalized for psychiatic reasons in the past

On psychiatric medications now

Taken psychiatric medications in the past

None of the above

.

Current suicidal thoughts

Attempted suicide in the past

Current or past self-harm

None of the above

Please provide additional detail on the above.

Thanks for submitting!

Ashley Bouzis is a psychiatrist, psychotherapist, therapist and yoga teacher in Seattle, WA

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