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



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.

Read more reviews



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.

Read more reviews



Very thorough, and understanding of my concerns. Thanks!

Tim T.

Read more reviews



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.

Read more reviews



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

Gertiude O.

Read more reviews



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.

Read more reviews



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.

Read more reviews



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.

Read more reviews



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.

Read more reviews



DR. LaBriola and his assistants Gaby and Constance were excellent…

William J.

Read more reviews



Dr. Jackson takes the time to get to know her patients before the surgical procedure starts. She thoroughly explained the steps of the procedure. She addressed every concern and answered all my questions before the procedure started. She is AWESOME!!

Julia A.

Read more reviews



Excellent, professional care at this facility.

Jerman F.

Read more reviews



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

Hagop A.

Read more reviews



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.

Read more reviews



The surgeon and nurses were great. Very helpful in making the right decision and the after care was outstanding.

Brian R.

Read more reviews



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

Pamela M.

Read more reviews



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

Anonymous

Read more reviews



I got more than I expected today. I was in pain, afraid, and unsure about how to best deal with the painful experience in my teeth. Everyone from the front desk to Dr. LaBriola exceed expectations I had. Thank you and may your business thrive!

Mekdes K.

Read more reviews



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.

Read more reviews



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.

Read more reviews

Request an appointment today

Request an Appointment Online

Site Navigation