Diver Medical | Participant Questionnaire (Can I dive?)

Most people can learn to scuba dive safely with us - let's make sure you're ready for your underwater adventure.

Safety First - Your Quick Medical Check

This 2-minute questionnaire helps us ensure your diving experience is both safe and amazing. It's a standard requirement that protects you and gives us the information we need to provide the best possible training.

What happens next: • Complete the questionnaire • We'll instantly tell you if you need medical clearance • If clearance is needed, simply get written confirmation from your doctor • Then you're ready to book your diving adventure!

Important: Please complete this questionnaire before booking any activities. If medical clearance is required and you book before receiving written doctor approval, we cannot provide refunds if you're unable to participate for medical reasons.

Ready to start? Click next below.

Let's start by collecting a few details

First Name *

Last Name *

Email *

Which experience or course are you interested in? *

I consent to Dive Academy contacting me regarding the information I give in this questionnaire for the purpose of assisting me with my course or experience booking.

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I have had problems with my lungs, breathing, heart and/or blood affecting my normal physical or mental performance.

Yes

I have / have had: Chest surgery, heart surgery, heart valve surgery, an implantable medical device (eg, stent, pacemaker, neurostimulator), pneumothorax, and/or chronic lung disease. *

Yes

I have / have had: Asthma, wheezing, severe allergies, hay fever or congested airways within the last 12 months that limits my physical activity/exercise. *

Yes

I have / have had: A problem or illness involving my heart such as: angina, chest pain on exertion, heart failure, immersion pulmonary edema, heart attack or stroke, OR am taking medication for any heart condition. *

Yes

I have / have had: Recurrent bronchitis and currently coughing within the past 12 months, OR have been diagnosed with emphysema. *

Yes

I have / have had: Symptoms affecting my lungs, breathing, heart and/or blood in the last 30 days that impair my physical or mental performance. *

Yes

I am over 45 years of age. *

Yes

I currently smoke or inhale nicotine by other means. *

Yes

I have a high cholesterol level. *

Yes

I have high blood pressure. *

Yes

I have had a close blood relative die suddenly or of cardiac disease or stroke before the age of 50, OR have a family history of heart disease before age 50 (including abnormal heart rhythms, coronary artery disease or cardiomyopathy). *

Yes

I struggle to perform moderate exercise (for example, walk 1.6 kilometres/one mile in 14 minutes or swim 200 meters/yards without resting), OR I have been unable to participate in a normal physical activity due to fitness or health reasons within the past 12 months. *

Yes

I have had problems with my eyes, ears, or nasal passages/sinuses. *

Yes

I have / have had: Sinus surgery within the last 6 months. *

Yes

I have / have had: Ear disease or ear surgery, hearing loss, or problems with balance. *

Yes

I have / have had: Recurrent sinusitis within the past 12 months. *

Yes

I have / have had: Eye surgery within the past 3 months. *

Yes

I have had surgery within the last 12 months, OR I have ongoing problems related to past surgery. *

Yes

I have lost consciousness, had migraine headaches, seizures, stroke, significant head injury, or suffer from persistent neurologic injury or disease. *

Yes

I have / have had: Head injury with loss of consciousness within the past 5 years. *

Yes

I have / have had: Persistent neurologic injury or disease. *

Yes

I have / have had: Recurring migraine headaches within the past 12 months, or take medications to prevent them. *

Yes

I have / have had: Blackouts or fainting (full/partial loss of consciousness) within the last 5 years. *

Yes

I have / have had: Epilepsy, seizures, or convulsions, OR take medications to prevent them. *

Yes

I am currently undergoing treatment (or have required treatment within the last five years) for psychological problems, personality disorder, panic attacks, or an addiction to drugs or alcohol; or, I have been diagnosed with a learning or developmental disability. *

Yes

I have / have had: Behavioral health, mental or psychological problems requiring medical/psychiatric treatment. *

Yes

I have / have had: Major depression, suicidal ideation, panic attacks, uncontrolled bipolar disorder requiring medication/psychiatric treatment. *

Yes

I have: Been diagnosed with a mental health condition or a learning/developmental disorder that requires ongoing care or special accommodation. *

Yes

I have / have had: An addiction to drugs or alcohol requiring treatment within the last 5 years. *

Yes

I have had back problems, hernia, ulcers, or diabetes. *

Yes

I have / have had: Recurrent back problems in the last 6 months that limit my everyday activity. *

Yes

I have / have had: Back or spinal surgery within the last 12 months. *

Yes

I have / have had: Diabetes, either drug or diet controlled, OR gestational diabetes within the last 12 months. *

Yes

I have / have had: An uncorrected hernia that limits my physical abilities. *

Yes

I have / have had: Active or untreated ulcers, problem wounds, or ulcer surgery within the last 6 months. *

Yes

I have had stomach or intestine problems, including recent diarrhea. *

Yes

I have had: Ostomy surgery and do not have medical clearance to swim or engage in physical activity. *

Yes

I have had: Dehydration requiring medical intervention within the last 7 days. *

Yes

I have had: Active or untreated stomach or intestinal ulcers or ulcer surgery within the last 6 months. *

Yes

I have had: Frequent heartburn, regurgitation, or gastroesophageal reflux disease (GERD). *

Yes

I have had: Active or uncontrolled ulcerative colitis or Crohn’s disease. *

Yes

I have had: Bariatric surgery within the last 12 months. *

Yes

I am taking prescription medications (with the exception of birth control or anti-malarial drugs other than mefloquine (Lariam). *

Yes

I am pregnant or I am attempting to become pregnant *

Yes