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

Anonymous

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Courteous, explain options in detail

Susan L.

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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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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. 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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My first visit was great! Everyone was really nice and welcoming. They made me feel very comfortable.

Breana O.

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By far the best experience I have had. My procedure was quick and I was in and out. Everyone was very nice and helped ease my nerves. I couldn’t have asked for a better experience. Dr. Zadeh is the best!

Nakeecha W.

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I was very pleased with my experience. Everyone is very personable and calm. All of the staff made me feel welcome and comfortable

Shelley R.

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Everyone friendly, helpful, knowledgeable , professional . No problem with scheduling. Had extraction with no ensuing pain, swelling or discoloration.

Anonymous

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Excellent staff who were courteous and knowledgeable.

Anonymous

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

Pamela M.

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I had all 4 wisdom teeth removed yesterday by Dr. Zadeh. I was very nervous because this was my first surgery ever. All of the staff was was great and explained every step including the sedation process and aftercare instructions. Before I took any medication, my pain was a 3/4 out of 10. This was a very positive experience and I highly recommend this practice.

Deandras 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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It was my first time i had an amazing experiance everyone is so friendly and great supporters.. thank you guys

Felicia A.

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It was the best experience. The workers were very friendly and made me feel comfortable.

Gertiude O.

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Everyone friendly, helpful, knowledgeable , professional . No problem with scheduling. Had extraction with no ensuing pain, swelling or discoloration. Dr LaBriola was my dental surgeon, EXCELLENT!

Anonymous

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My experience at the Norther Virginia Oral and Maxillofacial Surgery Associates in Annandale was awesome. The staff were incredibly friendly and professional. The facility was well-organized and clean. Everyone was well-informed and answered my questions. I was really put to ease during the entire process.

Chanel D.

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Excellent, professional care at this facility.

Jerman F.

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We love Dr.LaBriola he was so gentle with my daughter when she had her wisdom teeth out. Both of my daughter’s friends went to him too and they said the same thing 😊

Zhulieta D.

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