Complete the following medical self-assessment prior to your dive trip.

Note to women: If you are pregnant, or attempting to become pregnant, do not dive.

Recreational scuba diving and freediving requires good physical and mental health. There are a few medical conditions which can be hazardous while diving. If you have any concerns about your diving fitness not represented on this form, consult with your physician before diving. If you are feeling ill, avoid diving. If you think you may have a contagious disease, protect yourself and others by not participating in dive training and/ or dive activities. For your safety, and that of others who may dive with you, answer all questions honestly.

Question Title

* 1. Have you ever suffered any illness or injury that may affect your ability to dive or snorkel safely?