Medical Questionnaire

To The Participant:

Scuba diving is an exciting and demanding activity. To scuba dive you must not be extremely overweight or out of condition. Diving can be strenuous under certain conditions. Your respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with heart trouble, a current cold or congestion, epilepsy, asthma, a severe medical problem, or who is under the influence of alcohol or drugs, should not dive. If taking medication, consult your doctor before participating in this program.

The purpose of the Medical Questionnaire is to find out if you should be examined by a physician before participating in recreational scuba diving. A positive response to a question does not necessarily disqualify you from diving. A positive response means that there is a preexisting condition that may affect your safety while diving and you must seek the advice of a physician.

Please answer the following questions on your past and present medical history with a YES or NO. If you are not sure, answer YES. If any of these items apply to you, we must request that you consult with a physician prior to participating in scuba diving. Your PADI Professional will supply you with a PADI Medical Statement and Guidelines for Recreational Scuba Diver’s Physical Examination to take to a physician.

If you are doing a Discover Dive (aka you are not a certified diver), make sure you have reviewed the medical questions and can answer “No” to all the questions. If there is a “Yes” on any of the medical question this does not mean you cannot dive, just that before you dive you must get a doctor’s note stating clearly that you are okay to dive with this medical condition. You must review the medical questionnaire prior to reserving your tour. If you have a “Yes” on any of the questions please let us know, and we will send you a copy of the medical release form your doctor must sign to clear you for diving.

At the dive site prior to diving you will be required to fill out and sign the medical questionnaire. If anyone answers “Yes” to any of these questions they will have to provide a signed doctors note at that time stating that the medical condition does not prohibit you from diving. If you have answered “Yes” and do not have a doctor’s note you will not be able to dive that day and will still be charged for the price of the tour. You will have the option to reschedule if there is availability. If there is no availability then you will not be able to reschedule and will still be charged for the price of the tour.

  • Do you currently have an ear infection?
  • Do you have a history of ear disease, hearing loss or problems with balance?
  • Do you have a history of ear or sinus surgery?
  • Are you currently suffering from a cold, congestion, sinusitis or bronchitis?
  • Do you have a history of respiratory problems, sever attacks of hay fever or allergies, or lung disease?
  • Have you had a collapsed lung (pneumothorax) or history of chest surgery?
  • Do you have active asthma or history of emphysema or tuberculosis?
  • Are you currently taking medication that carries a warning about any impairment of your physical or mental abilities?
  • Do you have behavioral health, mental or psychological problems or a nervous system disorder?
  • Are you or could you be pregnant?
  • Do you have a history of colostomy?
  • Do you have a history of heart disease or heart attack, heart surgery or blood vessel surgery?
  • Do you have a history of high blood pressure, angina, or take medication to control blood pressure?
  • Are you over 45 and have a family history of heart attack or stroke?
  • Do you have a history of bleeding or other blood disorders?
  • Do you have a history of diabetes?
  • Do you have a history of seizures, blackouts or fainting, convulsions or epilepsy or take medications to prevent them?
  • Do you have a history of back, arm or leg problems following an injury, fracture or surgery?
  • Do you have a history of fear of closed or open spaces or panic attacks (claustrophobia or agoraphobia)?

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