151 N. Sunrise Avenue
Suite 1005
Roseville, CA 95661

Phone 916-782-1217
Fax 916-782-7630

Our Physicians

Thomas C. Merchant, M.D.
Tyler G. Smith, M.D.
Kevin P. Hansen, M.D.
Annie L. Nguyentat, DPM
Robert D. Jamieson, D.O.

Patient Forms

Welcome to Roseville Orthopedics

If you are a spine patient, we have a different form for you to fill out. It is six pages, of health care information and two pages of administrative information - address etc, and privacy form. total 8 pages.

Please print out the forms, fill them in, and sign as indicated.

Thank you and we will see you soon!

New Orthopedic Patient Forms

Spine / Neck Patient Forms

Foot / Ankle Patient Forms