Get the free Diving Medical History Form - ems psu

This document is intended for applicants who wish to participate in scuba diving and requires them to provide their medical history to assess their fitness for diving. It includes a series of questions

How to fill out diving medical history form

How to fill out Diving Medical History Form

1. Start with your personal information: Fill in your full name, date of birth, and contact details.
2. Indicate your diving experience: Provide details about your previous diving qualifications and number of dives.
3. Medical history: List any past or current medical conditions, surgeries, or treatments that may affect your diving.
4. Medication: Include a complete list of any prescription or over-the-counter medications you are currently taking.
5. Allergies: Note any allergies, particularly to medications or environmental factors.
6. Family medical history: Mention relevant health issues in your immediate family, such as heart disease or respiratory problems.
7. Review: Go through the form to ensure all information is accurate and complete.
8. Signature: Sign and date the form to confirm that the information provided is true.

Who needs Diving Medical History Form?

1. The Diving Medical History Form is required for anyone planning to participate in scuba diving or similar underwater activities, especially those with health concerns or prior medical conditions.

People Also Ask about

What are the prerequisites for diving?

– Good swimming skills – Swimming skills are an obvious requirement for scuba diving. Divers aren't expected to swim, but rather navigate through the water. – Good eyesight – You should have good eyesight to make sure that you can dive safely. – Good health – You should have a healthy body to dive safely.

What are the medical requirements for diving?

Your respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with coronary disease, a current cold or congestion, epilepsy, a severe medical problem or who is under the influence of alcohol or drugs should not dive.

What are the medical requirements for scuba diving?

Scuba diving requires heavy exertion. The diver must be free of cardiovascular and respiratory disease (see references, following page). An absolute requirement is the ability of the lungs, middle ears and sinuses to equalize pressure. Any condition that risks the loss of consciousness should disqualify the applicant.

What disqualifies you from diving?

Disqualifying Medical Conditions History of seizure disorder other than early childhood febrile (high fever) conditions. Significant anxiety, panic disorder and claustrophobia. Cystic or cavitary disease of the lungs, significant obstructive or restrictive lung disease, or spontaneous pneumothorax.

What conditions stop you from diving?

Specific Medical Contraindications to Diving ContraindicationSpecific Examples or Adverse Effects Structural disorder Unrepaired hernia Neurologic disorders Seizure disorder Recurrent syncope Metabolic disorders Extreme obesity Type 1 or type 2 diabetes mellitus treated with insulin (a relative contraindication)9 more rows

What is a medical certificate for diving?

Diver Medical Physician's Evaluation Form is completed by the physician evaluating the diving candidate for diving suitability when a physician's approval to dive is necessary. Diving Medical Guidance is a peer reference for physicians seeking additional information regarding how specific conditions relate to diving.

What is the medical condition for diving?

Disorders particularly associated with diving include those caused by variations in ambient pressure, such as barotraumas of descent and ascent, decompression sickness and those caused by exposure to elevated ambient pressure, such as some types of gas toxicity.

What is the medical evaluation for scuba diving?

DIVING MEDICAL EXAM OVERVIEW The diver must be free of significant cardiovascular and respiratory disease. An absolute requirement is the ability of the lungs, middle ear, and sinuses to equalize pressure. Any condition that risks the loss of consciousness must disqualify the applicant.

For pdfFiller’s FAQs

What is Diving Medical History Form?

The Diving Medical History Form is a document used to collect information about a person's medical history and health status, specifically related to scuba diving and other underwater activities.

Who is required to file Diving Medical History Form?

Individuals who intend to participate in scuba diving, particularly those taking diving courses or obtaining certifications, are typically required to file a Diving Medical History Form.

How to fill out Diving Medical History Form?

To fill out a Diving Medical History Form, an individual should provide accurate and complete information about their medical history, including any previous health issues, medications, and known allergies, as well as answers to specific health-related questions.

What is the purpose of Diving Medical History Form?

The purpose of the Diving Medical History Form is to assess the individual's fitness for diving, identify any potential medical risks, and ensure safety while participating in underwater activities.

What information must be reported on Diving Medical History Form?

The Diving Medical History Form typically requires information on personal health details, such as any pre-existing medical conditions, surgeries, medications, alcohol and drug use, and experiences with diving or related activities.