Diver's medical report | Participant Questionnaire
This form is principally designed as an initial medical screen for new divers but is also appropriate for divers taking continuing education.
For your safety, and that of others who may dive with you, answer all questions honestly.
Instructions
Complete this questionnaire as a prerequisite to a recreational scuba diving or freediving course.
The information provided about my medical history is accurate to the best of my knowledge and belief. I agree to accept responsibility for omissions in respect of any condition relating to my health whether existing or prior.
Note to women: If you are pregnant, or attempting to become pregnant, do not dive.