los gatos obgyn treating pelvic pains and routine visits

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Vital Health Forms

– Additional Resources

Forms for Prospective Patients
	Fill out and submit online: Request a Surgical Consult Review My Case Ask Dr. Cook
Forms for New Patients
	Print PDF form, write answers, and mail, fax, or scan/email:* Patient Registration Form New Patient Questionnaire – Pelvic Pain Medical Release Form General New Patient Questionnaire – No Pelvic Pain Fill out PDF form, print out, and mail/fax:* New Patient Questionnaire – Pelvic Pain Print out: Appointment Confirmation for Office Visit Phone Appointment Information Directions to Vital Health Institute Office Policies HIPAA Privacy Information
Forms for Surgery Patients
	Print out: Out of Area Surgery Timelines Herbs and Supplements to Avoid Prior to Surgery Things You Should Know About Anesthesiology What to Expect After Surgery
Forms for Existing Patients
	Fill out and submit online: Prescription Refill Request Print PDF form, write answers, and mail, fax, or scan/email:* Request for Letter VHI Medical Release to Another Doctor * Mail printed forms to 15055 Los Gatos Blvd., Suite 250, Los Gatos, CA 95032-2025. Or fax the printed forms to (408) 358-1009, Attn: Michelle. Or you may scan and email documents to michelle@vitalhealth.com.

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The content contained in this web site is for informational use only and is not intended as medical advice. You should always seek the advice and care of your local physician. Information on this web site is also subject to change without notice and may include technical inaccuracies or typographical errors.

Vital Health Institute is an international treatment center specializing in endometriosis, chronic pelvic pain, and minimally invasive laparoscopic surgery.
Women travel from throughout the U.S., Canada and countries worldwide for treatment by Dr. Andrew Cook and his dedicated, professional staff.