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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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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Dr. Zadeh is not only a very qualified oral surgeon, he is a very warm and easy to communicate with kind of person. I had a lower canine that had been root-canaled some time ago and ended up having a painful infection. He took out my infected tooth like he pulled out a needle from a butter, not feeling any pain at all. He then placed an imediate implant. He is very efficient in using his time and…

Zufan H.

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Had not had a tooth pulled in about 50 years so really could not remember what to expect. Things went pretty smoothly I’m pleased to report. Was sorry to hear that BC/BS stopped covering tooth extractions in 2015! Glad to have the infected tooth out of my mouth…appreciate being taken by your practice on short notice.

Barbara B.

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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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I’m afraid of all doctors but this was the best experience I’ve ever had. Everyone was extremely nice, with a warm inviting atmosphere. Their manager, Kelly was patient with all of my questions and helped me without hesitation. If I hear of someone needing surgery, this is who I’d recommend.

Jon M.

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Awesome people! I had my reservations based on some yelp reviews [mostly concerning other issues other than the procedure itself]. So I went in with an open mind not really concerning myself with anything else other than getting my four wisdom tooth extracted. I came out pleasantly surprised at how professional and cautious the staff were. I was able to walk to my car unaided, did prescription run…

Bendu F.

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I’ve had extensive dental work over the past decade. While all of the dentists and oral surgeons I’ve experienced in Northern Virginia have been professional and competent, This outfit is unquestionably the very best from the support staff to the doctors. Feel free to contact me for specifics.

Bob P.

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Wonderful staff!

Alethea W.

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I had a wonderful experience. Before the surgery I was very nervous but the surgeon and dental hygienist made me feel a little more comfortable for the procedure.

Meshala M.

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The staff were very helpful and friendly. Dr. Yadav was excellent and his assistantance were great.

Hazel B.

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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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Great staff

Anonymous

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

Anonymous

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Great experience. Everyone was calm and very reassuring during both my consultation and wisdom teeth removal visit. Despite my anxiety, everyone spent their time seeing if I had questions and tried to create a relaxing atmosphere before I had to go through with the surgery. Highly recommend anyone coming here. Clean and modern office with a 10/10 experience throughout.

Jennifer T.

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The staff made me feel comfortable, cause I was scared & don’t like needles.

Tamara L.

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Great sevice from wonderful individuals-thanks

David M.

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Very thorough, and understanding of my concerns. Thanks!

Tim T.

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Everything was great! From beginning to end! Any questions I had and any concerns they were all addressed and they did everything they could to make me as comfortable as possible.

Nicole D.

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I felt very confident that I was in a professional environment and that my doctor new exactly what he was doing.

Anonymous

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Went here for a second consult on my sons wisdom teeth removal. The staff at the front desk was very friendly and welcoming. Dr. Zadeh was very friendly and informative. After our consult visit I decided to go with this practice. The day of the surgery went very smooth. This practice is very organized and everyone worked together as a unified team to ensure that from start to finish there were no…

Jamie B.

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