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.

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Our patients leave smiling

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This letter is to follow-up with you sharing my experience before and after regarding being diagnosed at your office with Arthritis and describing pain in my jaw, ear, and neck pain etc. In the course of about a year, I went to urgent care, ear and throat specialists, twice to a dentist, two times to a primary care provider, had a sleep apnea test, hearing test and finally coming to your practice.…

Cecilia G.

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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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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 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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Dr Jackson is great. My experience was great

James C.

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

Tamara 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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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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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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Staff is professional and friendly which made my visit comfortable.

Brenda D.

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Wonderful staff!

Alethea 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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Professional staff who walked me through every phase of my tooth extraction with a calm and caring approach..

Veronica A.

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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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Excellent service. Dr. Haron is an experienced professional to trust with my dental health. Offer staff were nice and friendly. Thank you

Hagop A.

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

Anonymous

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I have been a patient for many years. Whenever I have needed a tooth removed I have gone to them. My experience has been pain free during the procedure and very little pain or swelling after. I would highly recommend the doctors at Northern Virginia Oral and Maxillofacial Surgery Associates.

Robert J.

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Great staff

Anonymous

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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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