Go where the wifi is weak and the Sun is strong

  1. Home
  2. Release Forms

Release Forms

Try Scuba Diving Medical Questionnaire and Liability Release


Each student is required to complete the SSI Fit To Dive Screening for which you need to answer the following questions about your past and present medical conditions to determine if you should be evaluated by a physician prior to scuba diving.

  
Do you currently have or have you been treated within the last 12 months for any of the following: 
1.    A heart, circulatory, blood, blood pressure, or bleeding abnormality that affects your ability to swim?  [ Yes ]  [ No ]
2.    A breathing or lung disorder (such as asthma or shortness of breath)?  [ Yes ]   [ No ] 
3.    Musculoskeletal, stamina, strength, or mobility disorders that affects your ability to swim?  [ Yes ]  [ No ]  
 
Download SSI Fit To Dive Form
 
If you answer [ Yes ] to one of the above questions, then you must additionally complete theDiver Medical Participant Questionnaire. This is a more thorough medical screening form used to determine if you need to be evaluated by a physician prior to any in-water diving activities.  If you answer “Yes” one of the initial 10 questions or “Yes” to one of the follow up questions, you are required to have your physician complete the Physician Evaluation Form prior to any in-water activity.  The third page of the form must be signed by a Physician (MD) and NOT a Nurse, Nurse Practitioner, or a Physician’s Assistant.

 
If you have any questions about your medical, mental or physical fitness to dive, you should also consult a physician to assess your individual risk factors. 

Download Form

Feel free to contact us with questions.

 

 

Scuba Medical Questionnaire with Doctor's Sign-Off Form

Medical Questionnaires are required before any recreational scuba activity. If any of these items apply to you, we must request that you consult with a physician prior to participating in scuba diving. Please print the entire document to share with your physician. Sign and fill out the questionnaire on page one with the complete words, "YES" and "NO." Your doctor should complete page two. Bring the completed, signed form with you to class. Students under the age of 18 need a signature from a parent or guardian.

Feel free to contact us with questions.
Download Form

top