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leavenworth ophthalmologist

Refer a Friend Program

Thanks for choosing Reifschneider Eye Center for your eyecare! We appreciate your business. As a token of our appreciation, we will put a credit of $50.00 on your account when a new patient comes in for service and acknowledges you as their referral source. This credit may used in our office, as you choose. Thanks again for your kind referrals. We value you as our best customers!

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Please print, fill out, and bring the following forms
with you to your appointment:

New Patient Information Form
Medical History Questionnaire
Assignment of Benefits/ Financial Agreement