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Please click on the title below to download the forms. Thank you!

Patient Intake Form
Pediatric Intake Form (Ages 0-11 years)
If your have digestive concerns, you may wish to complete a diet diary before your initial visit. Diet Diary Form


We welcome you as a patient and appreciate the opportunity to provide you with medical services from a naturopathic approach. We are excited to assist you on your path to optimal health!

Dr. Wiens has a general family practice and treats all types of patients, with added experience in chronic pain, women’s health, pediatrics, pregnancy care, and gastrointestinal health. She has a particular interest in Bowen therapy, a hands on technique to balance the nervous system and relieve pain.

What happens in my visits?

Your first visit to the clinic will involve completion of extensive intake forms in order to get a complete medical history. Your interview with Dr. Wiens will take an hour and fifteen minutes. She will ask you many questions about your symptoms, medical history, family medical history, lifestyle, and current supplements and medication. A physical exam will also be performed. This exam will give signs about your organ function, nutritional status, and hormone balance. You will be presented with some initial steps to begin treatment at this first visit. Please bring in the supplements and medications that you are taking, as well as any copies of recent blood work or reports from diagnostic procedures.

If your presenting health concern is pain or injury, Bowen therapy or Acupuncture will likely be started during your initial visit. For Bowen, you will need to book a return visit or two, each visit 7-14 days apart.

The second office visit is 30 minutes. Often this visit will include a nutritional assessment based on your diet diary (if required) and a review of the lab work that the doctor may have received. At this point she will also discuss any further laboratory testing that she may need to properly assess your health. Once Dr. Wiens has the information from your history, symptoms, physical exam, diet diary, and lab testing then she can determine what the underlying causes of your symptoms are and the best course of treatment. In this visit she will discuss in detail her findings, treatment goals, and expectations for your recovery. Often she will suggest a phased approach, first focusing on the chief complaints, then focusing on restoring optimal health. Many people are excited to learn how to prevent chronic disease, establish deep restful sleep, increase energy, maintain a healthy appetite, have less stress, and achieve their life goals.

Be prepared to be very involved in your treatment; you will need to be the one doing most of the work to get better. Dr. Wiens will be providing guidance and encouragement every step of the way.

Call the clinic to book your initial visit! Download forms above or the front desk can send you intake forms in advance via mail, fax, or email. 

Dr. Wiens is currently working Tuesday, Wednesday, Thursday, and Friday.

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