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.

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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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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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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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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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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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Dr Haron is very professional He and the staff took very good care of me. Dr went out of his way to make sure I was taken care of and not in any pain.

Catherine L.

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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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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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I had an abscess beneath my right back molar. The pain was unbearable. I was referred by a friend to NOVA Oral & Maxillofacial Surgery Associates by a friend. I couldn’t have been happier about my treatment, procedure and outcome. I am now pain-free. I was very impressed with the staff and service. In fact, I am about to schedule another appointment with them to install an implant for t…

Rob M.

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Excellent, professional care at this facility.

Jerman F.

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

Pamela M.

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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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I received excellent treatment. I would highly recommend this oral surgeon.

Antonio M.

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Dr Jackson is great. My experience was great

James C.

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

Anonymous

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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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I recently got my wisdom teeth extracted at this office and Dr. Hugh Zadeh did an excellent job. Quick and easy precedure and the recovery was much easier than expected with no swelling and almost no pain.

Kevin Y.

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