Health Status Questionnaire for Recreational Scuba Diving
Diving requires good physical and mental health. There are some medical conditions that can be dangerous while scuba diving, which are listed below. Those who have or are predisposed to any of these conditions should be evaluated by a physician. This Diver’s Physician Questionnaire provides a basis for determining whether you should seek such an evaluation. If you have any concerns about your diving fitness and they are not represented on this form, consult your physician before diving. References to «scuba diving» in this form cover both recreational scuba diving and freediving. This form is designed primarily as an initial medical examination for new divers, but is also appropriate for divers receiving continuing education. For your safety and the safety of others who may dive with you, answer all questions honestly.


Complete this questionnaire as a prerequisite for freediving or SCUBA training.
Note to women: If you are pregnant, or trying to become pregnant, do not dive.