Online Forms

Request An Appointment

Patient History Form

Medicaid

Contact Form

At ECA Nampa, we value your time. In an effort to save you time in our office, we welcome you to complete your patient history forms online prior to your appointment. Let us know what questions, concerns and goals your have regarding your eye health or vision on the form. Just click the link below to be directed to our history questionnaire. When you are finished, hit submit and you’re done!

If you cannot complete the online history form, please arrive 15 minutes prior to your appointment to fill out the questionnaire in our office. We look forward to meeting you!

Please complete this form as it lets us know the history and current state of your health.