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PADI MEDICAL QUESTIONNAIRE Padi Medical Questionnaire

St Croix SCUBA Medical Questionnaire

When you arrive to us to begin ANY scuba dive training we're going to have you complete a brief medical questionnaire.  

Check out the questions below.  If you can answer "NO" to all of the questions you're set to go.  Having a "YES" answer doesn't mean you can't participate, only that we'll need a physician's release prior to putting you in the water.  This is, of course, most easily done in advance from home rather on the morning that you're all set to start diving.  A LOT of people have "YES" answers so please don't feel like it's anything unusual.

 Medical Questionnaire

• Could you be pregnant, or are you attempting to become pregnant?
• Are you presently taking prescription medications? (with the exception of birth control or antimalarial)
• Are you over 45 years of age and can answer YES to one or more of the following:
     Currently smoke a pipe, cigars, or cigarettes
     Have a high cholesterol level
     Have a family history of heart attack or stroke
     Are currently receiving medical care
     High blood pressure
     Diabetes, mellitus, even if controlled by diet alone
Have you ever had or do you currently have
• Asthma, or wheezing with breathing, or wheezing with exercise?
• Frequent or severe attacks of hay fever or allergy?
• Frequent colds, sinusitis or bronchitis?
• Any form of lung disease?
• Pneumothorax (collapsed lung)?
• Other chest disease or chest surgery?
• Behavioral health, mental or psychological problems (Panic attack, fear of closed or open spaces)?
• Epilepsy, seizures, convulsions or take medications to prevent them?
• Blackouts or fainting (full/partial loss of consciousness)?
• Frequent or severe suffering from motion sickness (seasick, carsick, etc)?
• Dysentery or dehydration requiring medical intervention?
• Any dive accidents or decompression sickness?
• Inability to perform moderate exercise (example: walk 1.6km/one mile with 12 mins)?
• Head injury with loss of consciousness in the past five years?
• Recurrent back problems?
• Back or spinal surgery?
• Diabetes?
• Back, arm, or leg problems following surgery, injury, or fracture?
• High blood pressure or take medicine to control blood pressure?
• Heart disease?
• Angina, heart surgery, hearing loss or problems with balance?
• Recurrent ear problems?
• Bleeding or other blood disorders?
• Hernia?
• Ulcers or ulcer surgery?
• A colostomy or ileostomy?
• Recreational drug use or treatment for, or alcoholism in the past five years

 If you are going to answer "YES" to any of the questions above just download the PADI Medical Questionnaire form here.  
   Page 1 = the questionnaire above
   Page 2 = a release form for your physician to sign
   The remaining pages are informational for your physician in case s/he isn't familiar with scuba diving.