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

Pamela M.

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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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It such a pleasure working with Dr. Jackson and the crew. You all are amazing.

Maria S.

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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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It was an excellent experience. The staff was very helpful and cooperative. The doctor was very knowledgeable and kind. The doctor explained all the procedures and the steps plus his personal recommendations as if he was me, the patient.

Aly S.

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Dr. Zadeh and his implant team did an excellent job with my two implants. They all worked to put me at ease which made the procedure stress free. Thank you very much!

Shelley G.

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I was referred to NVOMSA by our family dentist, and I have t say I was very impressed with Dr. Zadeh and his staff. My son had all 4 wisdom teeth extracted and had a great experience. The procedure took about 1/2 and hour and my son is recovering very well, miniaml swelling. Overall and excellent experience. They did a great job with my son’s wisdom teeth extractions.

Jason K.

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Was able to be seen on very short notice – referred from primary dentist. Each of the four or five office staff members plus the dental assistants and the doctor I saw were courteous and professional and each clearly very knowledgeable in their respective areas. Evaluation and explanation of my needs was quick, efficient, thorough and clearly explained. I can’t imagine a better oral su…

Dan E.

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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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Well first off I have a fear of Dentistry. But the staff at Northern Virginia oral maxillofacial surgery put that completely at ease. This was the first and only time that I had dental work done without any fear or any pain. The front end staff is top notch..(Wendy & Gloria)..every question from procedures to payment was handled extremely well….I cant thank everyone enough..

Robert D.

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Excellent, attentive and very skillful

Christopher G.

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Dr. Jackson and her staffs are one of the best professionals I’ve met so far. They were ‘EXTREMELY’ patient and kind during the whole procedure. I highly recommend them.

Jacob K.

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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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Procedure was quick and efficient.

Richard G.

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

Sara B.

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Excellent service at a reasonable price. I had to have surgery right away, and they got me inside, got the surgery for much less than I expected to be charged and had an issue later when I got home. The Doctor called me herself, and followed up with me two more times to make sure everything was okay. There was very little pain and the swelling went down when they said it would, I highly recommend…

James M.

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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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