For a Lifetime of Good Vision | Contact Us

405-755-6111

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Patient Forms

Cataract Evaluation Paperwork

CATARACT Evaluation Paperwork

Refractive Lens Exchange Evaluation Paperwork

REFRACTIVE LENS EXCHANGE Paperwork

General Eye Exam Paperwork

General EYE EXAM Paperwork

LASIK Evaluation Paperwork

LASIK Evaluation Paperwork

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Patient Portal

Patient Satisfaction Survey

Which eyecare professional did you see for your appointment?

J. Chris Hummel, MD

Sherri Eakins, OD

Mark Privott, OD

Technician or Optician

At which location was your appointment scheduled?

Was an appointment available to you within a reasonable amount of time?

Yes

No

Do you feel your wait time in the reception area was too long?

Yes

No

Was the person you spoke with on the phone courteous?

Yes

No

Did the receptionist that greeted you for your appointment meet your expectations?

Yes

No

Was the technician that did your pre-testing knowledgeable and professional?

Yes

No

Was the receptionist at the checkout desk courteous?

Yes

No

Do you feel your doctor answered all your questions?

Yes

No

If you needed to schedule surgery, did your surgery coordinator explain everything to your satisfaction?

Yes

No

Does not apply to me

Do you feel you had a thorough eye examination?

Yes

No

Would you recommend our office to your friends and family?

Yes

No

How did you hear about us?

Other:

Please feel free to make any additional comments.

Name (optional)

Would you like our administrator to contact you?

Yes

No

Phone number:

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Hummel Eye Associates

4205 McAuley Blvd.

Suite 401

Oklahoma City, OK 73120

Phone: 405-755-6111

Fax: 405-755-6298

Email: cindy@hummeleye.com

Business Hours:

Mon - Fri: 8:00 am - 5:00 pm
Sat - Sun: Closed

Home
About Us
Doctors and Staff
Procedures
Conditions
FAQs
Testimonials
Patient Information
Blog
Contact Us

Home
About Us
Doctors and Staff
Procedures
Conditions
FAQs
Testimonials
Patient Information
Blog
Contact Us

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