This questionnaire helps determine whether you should see a doctor before taking a recreational diving course. Answering yes does not necessarily mean you cannot dive. It means a pre-existing condition may affect your safety and you should consult a doctor before diving.
During booking, our team will send you the medical form by WhatsApp or email, as agreed with you. Read the instructions provided and, if a medical evaluation is needed, take the form to your doctor before diving.
- Could you be pregnant, or are you trying to become pregnant?
- Do you regularly take any prescription or nonprescription medication? (Except birth control pills or antimalarial medication.)
- Are you over 45 and do any of the following apply to you?
- You smoke a pipe, cigars or cigarettes
- You have high cholesterol
- You have a family history of heart attacks or stroke
- You are receiving medical care
- High blood pressure
- Diabetes mellitus, even if controlled by diet alone
Do you have, or have you ever had…
- Asthma or wheezing when breathing or exercising?
- Severe hay fever or allergy attacks?
- Frequent colds, sinusitis or bronchitis?
- Any form of lung disease?
- Pneumothorax (collapsed lung)?
- A history of chest surgery?
- Claustrophobia or agoraphobia (fear of enclosed or open spaces)?
- Epilepsy, fits or seizures, or do you take medication to prevent them?
- Recurring migraines, or do you take medication to prevent them?
- Temporary loss of consciousness or fainting (full or partial loss of consciousness)?
- Frequent motion sickness, such as on boats or in cars?
- Dysentery or dehydration requiring medical attention?
- Any diving accident or decompression sickness?
- Difficulty performing moderate exercise, such as walking 1,600 meters in 12 minutes?
- A head injury with loss of consciousness in the past 5 years?
- Recurring back problems?
- Back or spinal surgery?
- Diabetes?
- Back, arm or leg problems caused by surgery, injury or fracture?
- High blood pressure, or do you take medication to control it?
- Heart disease?
- Heart attacks?
- Angina, heart surgery or blood vessel surgery?
- Sinus surgery?
- Ear disease, hearing loss or balance problems?
- Recurring ear problems?
- Bleeding or other blood disorders?
- A hernia?
- Ulcers or surgery for ulcers?
- A colostomy or ileostomy?
- Recreational drug use, or treatment for drug or alcohol addiction, in the past 5 years?