Patient Forms

Medical Release Form:


Technical Note:

You will need Adobe Acrobat Reader to view our Registration Form. Please download the free Acrobat Reader from Adobe’s website if it is not already installed on your system.

The security and privacy of your personal data is one of our primary concerns.

We have taken every precaution to protect your privacy.


If you wish us to release your medical records to you or another doctor, please fill out the following form and mail or fax it to:

Chad N. Allen, D.D.S.
Oral and Maxillofacial Surgery

1124 Pajaro Street
Salinas, CA 93901
Fax: (831) 757-5833




Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.