Donna Helton, DDS

 434-792-5416

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Patient Forms

New patients please fill out and submit the following forms before you first appointment: 

  • Patient Registration
  • Health History
  • Dental History
  • Health Information Disclosure Authorization (HIPPA)

Current patients please fill out and submit Annual Medical History Update once a year. 

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Patient Registration
Health History
Dental History
Health Information Disclosure Authorization
Annual Medical History Update
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Donna F. Helton, DDS, PC

1422 West Main Street
Danville, VA 24540

Phone: 434-792-5416
Fax: 434-792-7630

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