Appointment Request Form If this is an emergency, please contact 911. Please fill in the form below to setup an appointment.Location*Select your Family Eyecare Specialists locationCaldwell (Medicaid)Nampa (Medicaid)Reason for AppointmentPlease provide a reason for your appointment. Details are stored securely and not sent by email.Preferred Date & Times*Please let us know when you would prefer to have your appointment. Our hours are listed on our location page.Patient Type* New patient Returning patient Please let us know if you are a new or existing patient.Name* First Last Date of Birth* MM slash DD slash YYYY Phone*Email* Best Time to be Reached for Confirmation* : Hours Minutes AM PM AM/PM CommentsHiddensource_medium EmailThis field is for validation purposes and should be left unchanged.