The Great Plains Region in the United States has over 3,000 hospitals and clinics. Many lacking the outdoor amenities useful to individuals year-round. This study will focus on placing those amenities at the Sanford Medical Center in Fargo ND, newly constructed in 2017. Healing Gardens and Therapeutic Spaces are elements that help promote health yet are rarely built in the upper Midwest because of seasonal interest. From May to September, the weather is ideal but from October to April the cold temperatures, strong winds, flooding, and snow become an issue. An opportunity within constraint arises when designing for seasonal interest year-round through research-based design.“ Visibility, accessibility, familiarity, quietness, comfort, and unambiguously positive art” are the guiding principles put forward by Clare Cooper Marcus in Healing Gardens in Hospitals for generating successful healing gardens and therapeutic spaces. With those guidelines, I can ask: What are the central needs and concerns for the outdoor environment in a medical setting? What is desired by staff, patients, and visitors in a healing garden space? Why has this not been further explored and promoted in the Fargo area? The Sanford Medical Center serves as a medical hub for a population about 200,000, that includes the City of Fargo, West Fargo, Horace, plus the smaller surrounding towns. Being a level one adult trauma/emergency center, specializing in family birth, children’s hospital, brain and spinal surgery, heart surgery, interventional cardiology, and general surgery, gives more than enough reason to implement a place of de-stressing and quietness to the property. To obtain the highest priority elements for a healing garden and therapeutic space, a user-preference survey was provided to staff and visitors on the topics of rooftop gardens, open lawn space, types of vegetation, path usage, gardening opportunities, and more. The whole design concept for this project is so that the users have a place they want to go to, because they had a say in every aspect of it, which helps take off some of the stress, gives distraction from illness, and provides comfort through familiarity. In addition, the survey helped provide measurability to the research conducted. The project site visit will show the measurable opportunities for desired elements. Case studies, books, articles, and previous thesis proposals are influential in showing how, why, where, and when this has been done in the past. The successes and guidance of the topics mentioned in those literatures is key.