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

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



Excellent, professional care at this facility.

Jerman F.

Read more reviews



It was my first time i had an amazing experiance everyone is so friendly and great supporters.. thank you guys

Felicia A.

Read more reviews



Unfortunately we had to be seen for an emergency situation. Dr. Haron was very thorough with informing us of what was to be expected. He was spot on with what happened and what he told us to expect. His calm, gentle demeanor was quite settling for us.

Anonymous

Read more reviews



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.

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



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

Brian R.

Read more reviews



Referred here after my first dentist wasn’t comfortable taking out my lower wisdoms. They fit me in the schedule same day and before I knew it, I was done and recovering.

Te-von H.

Read more reviews



Very friendly and professional staff. Did an excellent job with a tooth extraction I needed.

Michael S.

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



Great staff

Anonymous

Read more reviews



The doctor was very nice and very concern about me.

Rose C.

Read more reviews



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

Dimitri 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



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



Oh wow I’m so happy that I went there to extract my tooth.as soon as the dentist start he was done I was so surprised.my detist refer me there because I have high blood pressure he said that he didn’t want to risk taking the tooth out because it’s possible I will have complications.I’m very happy that I went there.I don’t remember the dentist name but he was wonderful…

Shermaine F.

Read more reviews



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.

Read more reviews



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

Pamela M.

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



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

Request an appointment today

Request an Appointment Online

Site Navigation