Medical Questionnaire

Recreational scuba diving is a fun and exciting, but physically demanding activity. This Medical Questionnaire is used to find out if you should be examined by a physician before participating. Keep in mind that a YES answer does not necessarily disqualify you from diving. It simply means that there is a preexisting condition that may affect your safety and you must seek the advice of a physician before scuba diving. This questionnaire is part of the booklet that you will fill out with your instructor when you check in for your Discover Scuba Dive, however, we do ask participants to take a moment to look over the questions beforehand, just to make sure they have all NO answers. If you do have a YES answer, we will need to have a PADI Medical Statement signed by your physician on file before we can take you diving.

  • 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, severe attacks of hayfever 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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