Required paperwork for your Scuba Refresher Session
This Medical Statement participant record is required to be filled out prior to your underwater adventure
This is a statement in which you are informed of the risks of skin and scuba diving. The statement also sets out the circumstances in which you participate in the diving at your own risk. Your signature on this statement is required as proof that you have received and read this statement. It is important that you read the contents of this statement before signing it. If you do not understand anything contained in this statement, then please discuss it with your instructor. If you are a minor, this form must also be signed by a parent or guardian.
The basic medical questionnaire needs to be filled out prior to your pool session. We must ask that you pay close attention to the instructions on the form.
Please answer the questions on your past and present medical history with a YES or NO. If you are not sure, answer YES.
On page 1, if you answer yes to Q3, Q5 or Q10, you will need to take the form to your doctor, if you answer yes to the others, you will need to turn to the second page of the questionnaire and read the corresponding boxes for further clarification.
If any of these items apply to you, and you have answered YES, we must request that you consult with a physician prior to participating in scuba diving. Your instructor will supply you with a PADI Medical Statement and Guidelines for Recreational Scuba Diver’s Physical Examination to take to a physician.
The purpose of this medical history questionnaire is to find out if you should be examined by a doctor before participating in recreational scuba diving. A positive response to a question does not necessarily disqualify you from diving. A positive (yes) response means that there is a pre-existing condition that may affect your safety while diving and you must seek the advice of a physician.
Please download this form and fill the top section out. This is then yours to keep to take with you on your holiday or next dive trip to show you have completed the Scuba Refresher session.