Patient Intake Forms and Handouts

PATIENT FORMS

Please fill in the following form prior to your visit. If you are unable to fill the form ahead of time, please arrive to your first appointment 15 minutes early to complete the paperwork. 

If possible, please bring in any current medications and supplements.

EXTENDED HEALTH

If you have extended coverage, please inquire with your plan administrator or coverage booklet for reimbursement rates and procedures. 

Please note: Dr. Wong is a naturopathic physician and a registered acupuncturist. Extended health plans may have different coverage for naturopathic and acupuncture care. For acupuncture treatment, your extended health plan may be able to be first billed under the acupuncturist and then subsequently under the naturopathic treatment once the acupuncturist coverage is complete.

For your convenience, we accept all standard methods of payment including Visa, MasterCard, and debit.

24 hours advance notice is requested for canceling or rescheduling appointments. A cancellation fee may be charged otherwise .

PATIENT HANDOUTS

Diet and Food:

• Basic Candida Diet

• Better Butter

• Diet Diary

• Heavy Metal Detox Recipes

• High Fibre and Low Fat Recipes

• Non-Dairy Sources of Calcium

• Nut Muffin Recipe

• Oxalate Content of Foods

• Smoothie Ideas

Women's Health:

• Menopause Rating Scale

• NAMS Menopause Questionnaire

• PMS Chart

Other:

• 24 Hour Glucograph

• Breathing Exercises

• Wet Sock Treatment

CONTACT INFORMATION

#8 - 310 Goldstream Ave.,
Victoria, BC, Canada V9B 2W3

Phone: (250) 478-4057

CLINIC HOURS

Monday: 9am to 6pm
Tuesday: 10am to 7pm
Wednesday: 9am to 4pm
Thursday: 10am to 7pm
Friday: 9am to 1pm
Closed Saturday and Sundays

CONTACT US