Contact and Appointments
HAROLD F. ROTH, D.O.
1627 Lake Lansing Road
Suite 200
Lansing, MI 48912-3788
Phone
(517) 485-1789
Fax
(517)485-2357
Business Hours
Monday - Friday: 8:00am-4:00pm Closed Daily from Noon to 2:00pm
New Online Presence
Explore our new website to find out everything about our practice.
Patient Information
Everything you need to know about your visit to the doctor.
Forms for New office Patients -- see forms for afc facilities for the adult foster care patients
2018 Forms
Ongoing Office Policy 2018 Form
ONGOING OFFICE POLICY 2018-PINK-123017.p[...]
Adobe Acrobat document [131.4 KB]
ONGOING OFFICE POLICY 2018-PINK-123017.p[...]
Adobe Acrobat document [131.4 KB]
Insurance Authorization and Assignment of Benefits
INSURANCE AUTHORIZATION AND ASSIGNMENT O[...]
Adobe Acrobat document [200.1 KB]
INSURANCE AUTHORIZATION AND ASSIGNMENT O[...]
Adobe Acrobat document [200.1 KB]
Sports Physical and Preschool Physical Forms
Preschool Physical Form
PHYSICAL FORM FOR PRESCHOOL-BCAL-3305_09[...]
Adobe Acrobat document [50.2 KB]
PHYSICAL FORM FOR PRESCHOOL-BCAL-3305_09[...]
Adobe Acrobat document [50.2 KB]
MVA & Workers' Comp Questionnaires
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