Downloadable Forms

To reduce your waiting time during your visit, we have provided several forms that you can download, read (and where appropriate, complete and sign) and bring with you. Please see the instructions included on each form.

These forms require the Adobe Acrobat Reader.

Download Acrobat Reader

Downloads

Patient Information and Medical Record

For all new and existing patients. Please complete the online registration form for the office you scheduled an appointment with for your surgical care. Annandale Woodbridge Manassas

Our payment policy

An explanation of the payment policy of Northern Virginia Oral and Maxillofacial Surgery Associates, including options for payment and insurance filing. Please print, read carefully and sign, and bring with you on your visit. Download

Authorization to Release Health Care Information

For any patient who wants to authorize our practice to release their medical information to a third party. Please complete and sign, and mail or deliver to our office. Download

Notice of Privacy Practices for Protected Health Information

A summary of the rules protecting the privacy of your medical information. Please print, read carefully, complete and sign, and bring with you on your visit. Download

Request for Medical / Dental Record

The purpose of this letter is to request copies of your medical records as allowed by the Health Insurance Portability and Accountability Act (HIPAA) and Department of Health and Human Services regulations. Download

CareCredit

CareCredit is a healthcare credit card designed for your health and wellness needs. Pay for the costs of many treatments and procedures through convenient monthly payments.

Three Convenient Locations to Serve You

We have three locations in the Northern Virginia area including Annandale, Manassas and Woodbridge. To find an office near you, click the link below.

Find your location

Our patients leave smiling

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Staff is professional and friendly which made my visit comfortable.

Brenda D.

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The staff is very courteous and was gentle with my 89 year old parent.

Anonymous

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Dr. LaBriola and the staff are the BEST!!!! So attentive and patient with clients like myself who require a little extra TLC!!

Tina B.

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Had my wisdom teeth extracted yesterday and opted out of sedation. Needless to say, I was a bit nervous. But after 25 minutes I was checking out and felt great. I couldn’t talk much, but the entire process was fast and efficient. Now 24 hours later, I’m thinking I would be perfectly fine to go back to work tomorrow morning! I am very appreciative that I was recommended to this OMFS off…

Kassandra M.

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Dental procedure went well. I am very pleased with how I was treated by the staff.

Anonymous

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Very friendly and professional staff. Did an excellent job with a tooth extraction I needed.

Michael S.

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Dr. Labriola was above and beyond excellent. I had four wisdom teeth removed and a root canal yesterday and have had virtually no pain or swelling. The recovery has been extraordinary. Dr. Labriola and his staff are true professionals, if you are considering this practice look no further! My procedure was painless and comfortable!

Erika B.

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Everyone in the office was very friendly and informative. Dr. Zadeh is a wonderful oral surgeon. He puts you at ease and explains everything very well. My recovery went exceedingly well, which was a testament to his expertise.

Anthony W.

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Great customer service. Doctor was very informative and made procedure as painless as possible. Staff is very welcoming

Anonymous

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Very pleasant and helpful people. The doctor that did my daughters surgery explained everything. Has a great bedside manner. Just want to thank them for all they do. I pray many blessings over you all.

Connie D.

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Very professional and knowledgeable staff. I would 100% recommend this practice. The staff very thoroughly communicated with us, not only about the procedures, but also about the billing. I felt like my son was in the best hands for his wisdom teeth extraction. Thank you for making this a smooth process!

Anonymous

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Dr. Jackson was extremely professional, patient, informative as well as friendly and enjoyable. She explained everything in great detail before my procedure. My personal dentist, Dr. Jones, recommended her. I knew if Dr. Jones recommended her she had to be great. My procedure was exactly as she explained. Her assistant Rosemary was also wonderful. I highly recommend Dr. Jackson to anyone reading t…

Maria S.

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Great staff. Dr. Jackson was also great. Very professional but personable and answered all my questions with patience.

Melissa K.

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Always a thoughtful caring approach. You are informed and reminded how to take care of your self with respect to the surgery. A compassionate approach that is fully patient centered with a dentist who is fully present to your needs in the moment.Much appreciated.

A.Vincent

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I am very glad that I was recommended to this OMFS dental office for my wisdom teeth extractions. I had made the decision early that morning that I would opt out of sedation, so I was very nervous going in. The staff eased my nerves tremendously by educating me about the procedure and letting me know that it was only going to take 20-30 minutes –and they were right. Now it’s 2 days aft…

Kassy M.

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Unfortunately we had to be seen for an emergency situation. Dr. Haron was very thorough with informing us of what was to be expected. He was spot on with what happened and what he told us to expect. His calm, gentle demeanor was quite settling for us.

Anonymous

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Great staff!, Doctor Jackson was amazing made getting my wisdom teeth out a great experience!

Sara B.

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Oh wow I’m so happy that I went there to extract my tooth.as soon as the dentist start he was done I was so surprised.my detist refer me there because I have high blood pressure he said that he didn’t want to risk taking the tooth out because it’s possible I will have complications.I’m very happy that I went there.I don’t remember the dentist name but he was wonderful…

Shermaine F.

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Excellent surgeon, dental assistant and front desk staff. Thank you! *Updated 6/27/17

Pamela M.

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Despite all my nerves, my experience was really great! The staff was very helpful and patient with me and they were easy to talk to. I had minimal pain and discomfort during and after my wisdom teeth extraction. I healed surprisingly fast after the procedure, too! I would absolutely recommend to a friend or to someone who is looking for an oral surgeon!

Ilana D.

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