1104 West High St., Unit 4A
Ebensburg, PA 15931

 BROUSE

 CHIROPRACTIC & NUTRITION

ADULT AND CHILDREN'S HEALTH HISTORY

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?




















AUTOMOBILE ACCIDENT

If your health issue is the result of a car accident, we need some additional information.






WORKER'S COMPENSATION

If your injury is the result of an injury from work, this information will help us help you.






ONLINE FORMS

(814) 472-9355


NEW PATIENT PAPERWORK



  • Brouse Chiropractic & Nutrition offers our patient form(s) so they can be completed in the convenience of your own home or office.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring them with you to your appointment.