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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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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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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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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The staff was wonderful, helped me relax and told me a lot to details of how the procedure will be. I’ve never had surgery before but they explained what will happen and gave me good advice. After the surgery, they helped me to get settle after the procedure and gave in detail of how to care for myself after the surgery. Thanks to Dr. LaBriola and the staff for making my first oral surgery c…

Sharie B.

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Best oral surgeon office in the DC area! Dr. LaBriloa is an amazing doctor and is the greatest!

Dimitri G.

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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.

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Had my wisdom teeth extracted yesterday and opted out of sedation. Needless to say, I was a bit nervous. But after 25 minutes I was checking out and felt great. I couldn’t talk much, but the entire process was fast and efficient. Now 24 hours later, I’m thinking I would be perfectly fine to go back to work tomorrow morning! I am very appreciative that I was recommended to this OMFS off…

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

Tamara L.

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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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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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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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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.

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The doctor was very nice and very concern about me.

Rose C.

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It is my first time in this place I was treated with a professional the girls who are at the front all very kindly make it feel like at home very friendly nurses and doctors

Marta H.

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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 am very glad that I was recommended to this OMFS dental office for my wisdom teeth extractions. I had made the decision early that morning that I would opt out of sedation, so I was very nervous going in. The staff eased my nerves tremendously by educating me about the procedure and letting me know that it was only going to take 20-30 minutes –and they were right. Now it’s 2 days aft…

Kassy M.

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

William J.

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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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