Do This First
Important Medical Form
For your safety and to avoid delays in your course:
Carefully read the form and answer the Medical History Questions honestly.
If you can answer "Yes" to question 3, 5, or 10, OR any question on page 2, then written clearance to dive, without restrictions, from a physician is required prior to any in-water activities. Immediately do the following:
Take or send all 3 pages of the form to your physician (MD or DO).
Ask your physician to complete the PHYSICIAN section on Page 3 of the form and return the form to you.
Student Divers who are professional physicians may not sign for approval on their own medical form.
Make a copy of the completed form and put it in a safe place. You may need it in the future.
Bring the completed original form to your first course session.
Give your completed Diver Medical Form to your instructor at your first course session. Otherwise, your training will be delayed.
For questions regarding your fitness to scuba dive, please speak with your physician. You and/or your physician can also speak with Diving Medicine Specialists at Divers Alert Network at no charge. Contact the Divers Alert Network (DAN) non-emergency medical information line at 919-684-2948 (Monday-Friday, 8am-4pm CT). Referrals to local diving and hyperbaric medicine specialists are available.
Additional Form Required for Student Divers Under Age 18
A parent/legal guardian must complete the form. Give the completed consent form to the instructor at the first course session.
Additional Form Required for Student Divers Under Age 12
A parent/legal guardian must review the flipchart together with the student diver.
A parent/legal guardian must complete the Acknowledgement Form together with the student diver. Give the completed acknowledgement form to the instructor at the first course session.