Medical Check List

Check List

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The purpose of this statement is to identify any conditions you may have or may have had which may prevent you from diving.

If the answer is YES to any of the questions listed below we will require you to see a doctor before you can commence diving. We can arrange for you to see a doctor while here, but it would be preferable for you to see your own doctor or a specialist “hyper baric” doctor if you have any concerns and to prevent disappointment if you cannot dive.

– Could you be, or are you trying to become pregnant?
– Are you currently taking pre

scription medications, (excluding birth control and anti-malarial)
– Are you over 45 and can answer YES to one or more of the following;
* currently smoke
* have a high cholesterol level
* have a family history of heart attacks or strokes
* history of high blood pressure
* are currently receiving medical care
* diabetes mellitus, even if controlled by diet alone

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Have you ever had or currently have;
– Asthma, or wheezing?
– Frequent or severe attacks of hay fever or allergy?
– Frequent colds, sinusitis or bronchitis?
– Any form of lung disease?
– Collapsed lung (pneumothorax)?
– History of chest surgery or disease?
– Claustrophobia or agoraphobia?
– Behavioral health problems?
– Epilepsy, seizures, convulsions or medication for them?
– Recurring migraines or medications for them?
– History of blackouts or fainting?
– Severe or frequent motion sickness?
– Dysentery or dehydration requiring medical intervention?
– Inability to perform moderate exercise, eg,walk 1.6km (1 mile) within 12mins?
– History of diving accidents or decompression sickness?
– Head injury with loss of consciousness in the last 5 years?
– History of recurrent back problems?
– History of back surgery?
– History of diabetes?
– Back, or limb problems following accident or surgery?
– High blood pressure or medication to control it?
– History of heart disease?
– History of heart attacks?
– Angina or heart surgery or blood vessel surgery?
– History of sinus surgery?
– Ear disease, hearing loss or balance problems?
– Recurrent ear problems?
– History of bleeding or blood disorders?
– History of any type of hernia?
– History of ulcers or ulcer surgery?
– History of colostomy or ileostomy?
– History or drug or alcohol abuse?

Please remember that these questions are to ensure your safety and if you have any concerns to see your doctor and get written confirmation that you are fit to dive.
For more information and comprehensive Diving insurance contact Dan (Divers Alert Network)DAN

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