Book Discover Scuba Diving

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Are all participants confident swimmers able to swim 200m unassisted?
YesNo

Medical Questionnaire. Please read carefully through the following medical form. Please be aware that if you tick yes to any of the following you will need to get a dive medical to go diving. A certificate of clearance would need to be shown to the Instructor on the day. Do any participants in this booking suffer from or have they in the past suffered from any of the following conditions:

YesNo Asthma or wheezing
YesNo Fainting, seizures or blackouts
YesNo Chronic sinus condition
YesNo Chest surgery
YesNo Recurrent Ear problems when flying
YesNo Epilepsy
YesNo Diabetes Mellitus (Sugar Diabetes)
YesNo Tubercolosis or long-term lung disease
YesNo Brain, spinal cord or nervous disorder
YesNo Heart disease of any kind
YesNo Collapsed Lung
YesNo Ear surgery

Do any of the persons in this booking currently suffer from :

YesNo Chronic Ear discharge or infection
YesNo Breathlessness
YesNo High Blood pressure
YesNo Perforated eardrum
YesNo Other illness or operation within the last month
YesNo Are any of the persons taking any medicine or drug (excl. Oral contraceptives)?
YesNo Are any of the persons in this booking pregnant?
YesNo Are you planning to fly within 24 hours of completing your dive?

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