Consumer Comments and Questions

The OMMU Wants to Hear From You!

Please inform us of your comments and questions by filling out and submitting the form below. 
Should you have a complaint about your qualified physician, you may file it here.

Please note, under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity; instead, contact our office directly by phone or in writing.

 

Required fields are marked with an asterisk (*)

First Name:

Last Name:

Email:

Phone:

Type: *

Patient Number (if applicable):

City:

State:

Zip Code:

Comment Type: *

Please describe your comment or question: *