Diver Medical Questionnaire

Scuba diving is an exciting and rewarding activity, but it comes with certain risks and responsibilities. This Medical Questionnaire is designed to inform you about potential health risks and the required conduct during your scuba training. Your signature is necessary to participate. If you are under 18, a parent or guardian must also sign this form.

Important Information

For your safety, it’s critical that your respiratory and circulatory systems are in good health. Diving can be physically demanding, so individuals who are significantly overweight or out of condition may find it more challenging. All air spaces in your body must function normally and healthily.

Do not attempt to scuba dive if you have or are experiencing any of the following without medical clearance:

• Coronary disease
• Current cold or nasal congestion
• Epilepsy
• Severe medical conditions
• Influence of alcohol or drugs

If you have asthma, heart disease, other chronic health conditions, or you take regular medications, it is recommended that you consult your doctor and inform your instructor before starting the program. This also applies if your health condition changes at any point during or after your scuba program.

Safety First

Your instructor will teach you vital safety techniques, including proper breathing and equalizing while underwater. It’s also important to understand that improper use of scuba gear can result in serious injury. Training and practice under the supervision of a qualified instructor are essential to your safety.