Patient Info Form

If you are scheduled for an appointment in our office, print and complete this form and bring it with you. Please be thorough, as this information is used by the doctor to manage your care, and by the bookkeeper to bill your insurance(s) appropriately and minimize any out of pocket expense.

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  • Our practice specialty lies in the treatment and management of degenerative corneal conditions like Keratoconus. Using our in-office laboratory and expertise, we are able to offer distinct advantages to the Keratoconic patient, which will translate to optimal visual acuity and comfort.

    Keratoconus Treatment

  • Are there any alternatives for correcting vision besides refractive surgery? What if we could non-surgically change corneal shape in a controlled manner while the patient sleeps, resulting in excellent visual acuity during waking hours without the use of glasses or daytime contact lenses? We can!

    Corneal Reshaping

    • Selecting new glasses has become one of the most enjoyable parts of my eye appointment.  The team takes time to make outstanding recommendations that put me in both comfortable and stylish glasses.  I’m never rushed and always happy with the …

      - Ed S.
    • Dr. Buffington’s sincere commitment to providing the best possible care along with the assistance of his right hand Debbie, was second to none. When Dr. B chose to slow down and added Dr. Rembleski as his colleague, it quickly became very apparent why he chose him.

      - Jeff H.
    • The Corneal Reshaping program is a must for sports. Being a tri-athlete, I don’t have to worry about my goggles leaking and water getting on my contacts.

      - John R.
    • My husband Steve and I have been patients since 1986. Our vision has always ben clear and stable, and we are now wearing bifocal contact lenses. We highly recommend and trust these Doctors and their staff.

      - Susan T.
    • The staff is friendly, helpful and courteous and Dr. Rembleski shows true concern for my well-being. He is knowledgeable and stays current on research while offering the latest products available. River City Doctors of Optometry is the perfect place for your eye care!

      - Donna T.