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

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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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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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Great sevice from wonderful individuals-thanks

David 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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Great staff!, Doctor Jackson was amazing made getting my wisdom teeth out a great experience!

Sara B.

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Office is professional, pleasant and efficient. Dr. Labriola and the staff are great.

Suzanne D.

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

Antonio M.

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

Anonymous

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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 surgery pr…

Dan E.

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Dr Jackson is great. My experience was great

James C.

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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 after the p…

Kassy M.

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The staff was very nice and helpful at each step of the way. Dr. Labriola is terrific, just as I remembered him.

Anonymous

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Dr. LaBriola and the staff are the BEST!!!! So attentive and patient with clients like myself who require a little extra TLC!!

Tina B.

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Excellent service at a reasonable price. I had to have surgery right away, and they got me inside, got the surgery for much less than I expected to be charged and had an issue later when I got home. The Doctor called me herself, and followed up with me two more times to make sure everything was okay. There was very little pain and the swelling went down when they said it would, I highly recommend…

James M.

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Courteous, explain options in detail

Susan L.

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

Pamela M.

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Excellent staff who were courteous and knowledgeable.

Anonymous

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