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

    • 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.
    • 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.
    • Thank you for your 15 years of fabulous service to my family and me! I love seeing all of you…Pam, Dr. R, Dr. L., Fred, etc. etc. (wonderful staff). You’re like family. Thanks again for your kindness!

      - Patty G.
    • I am extremely happy and completely trust Dr. Rembleski with the care of our family’s vision. Dr. Rembleski is interactive and patient making the kids feel comfortable. He takes the time to listen to our concerns and questions and is very thorough.

      - Kristen S.
    • Before I came to this office I had tried wearing soft lenses, but … the toric lenses would spin a bit with every blink, making my vision whirl just a little. Then Doctor Rembleski fitted me with rigid gas permeable lenses, and now I have awesome vision.

      - Rich M.