MEDICAL STATEMENT FORM

Before participating in scuba certification class, you will need to complete and sign the Diver Medical Participant Questionnaire form. You can download a copy of this form, in Adobe Acrobat Portable Document Format (PDF), using the link on the right.

 

Assuming you can honestly answer NO to all of the questions, bring the signed form with you to class.

What if I have to answer YES? Don’t panic. It just means that you have a condition that requires a physician’s approval prior to taking part in any in-water activities. Here is what you do:

  • Take the completed Medical History form to your physician, along with the Diving Medical Guidance to the Physician (12 Pages).
  • Discuss the medical history/exam form and guidelines with your physician. If he or she has a question, the guidelines have a number at DAN (Divers Alert Network) you can call.

Assuming your physician is okay with you diving (which is generally the case), he or she can sign the form where indicated on the back. Bring the signed form with you when you arrive for class.

This is Important: You must either bring:

  • The medical statement form with a NO to all questions, or ...
  • The same form with one or more YES's — but signed by your physician.

Without this you will not be allowed to participate. No exceptions.