Are you Fit to Dive?
This is a statement in which you are informed of some potential risks involved in scuba diving and of the conduct required of you during the scuba training programme. Your acceptance and signature on this statement are required for you to participate in the in-water scuba training programme offered.
Read this statement before accepting the risk as your instructor will require this statement to be signed before any in-water training has commenced. If you are a minor, you must have this statement signed by a parent or guardian before any in-water training.
Diving is an exciting and demanding activity. When performed correctly, applying correct techniques, it is relatively safe. When established safety procedures are not followed; however, there are increased risks. To scuba dive safely, you should not be extremely overweight or out of condition. Diving can be strenuous under certain conditions. 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. If you have asthma, heart disease, other chronic medical conditions or you are taking medications on a regular basis; you should consult your doctor and the instructor before participating in this programme, and on a regular basis thereafter upon completion. You will also learn from the instructor the important safety rules regarding breathing and equalization while scuba diving. Improper use of scuba equipment can result in serious injury. You must be thoroughly instructed in its use under the direct supervision of a qualified instructor to use it safely.
If you have any additional questions regarding this Medical Questionnaire Statement or the Medical Questionnaire section, review them with your doctor before accepting liability and signing.
The purpose of this Medical Questionnaire Statement is to find out if you should be examined by your doctor before participating in recreational diver training. A positive response to a question does not necessarily disqualify you from diving. A positive response means that there is a pre-existing condition that may affect your safety while diving and you must seek the advice of your physician before engaging in dive activities.
Please answer the following questions on your past or present medical history with a YES or NO. If you are not sure, answer, YES. If you answer YES to any of these questions and a doctor's clearance is required before any in-water activities, you may still proceed with the academic section of the diver training, although it must be noted that if you continue to make a booking and you are required to obtain a Medical Clearance certificate, and due to any reason whatsoever you are not able to obtain Medical Clearance, NO refund will be given.
Every student taking a diving course with us is required to complete this medical questionnaire. If a dive medical is required, a copy must be emailed to email@example.com, before your course starts.
|Caringbah||02 9540 1266||42 President Avenue||Caringbah||NSW||2229|
|Chatswood Medical Centre||02 9411 4464||781 Pacific Highway||Chatswood||NSW||2067|
|Coogee Family Medical||02 9315 8999||201 Coogee Bay Rd||Coogee||NSW||2034|
|Coogee Medical Centre||02 9665 4344||21 Carr Street||Coogee||NSW||2034|
|Cronulla||02 9527 3773||18 Laycock Avenue||Cronulla||NSW||2230|
|Dr Albert Galea||02 4322 7249||Shop 4, 278 Mann Street||Gosford||NSW||2250|
|Dr Amy Ho||02 9906 2544||38 Pacific Highway||St Leonards||NSW||2065|
|Dr Chee Leong Hiew||02 4365 2983||58 Karalta Rd||Erina||NSW||2251|
|Dr Harry||02 9389 8000||248 Bondi Road||Bondi||NSW||2022|
|Dr JN Parikh||02 9489 3560||58 Denman Pde||Normanhurst||NSW||2076|
|Dr Johan de Kock||43655322||Erina Fair Shopping Centre||Erina||NSW||2250|
|Dr John Harris||02 43321300||120 The Entrance Road||The Entrance||NSW||2261|
|Dr Jon Levenston||02 9977 7612||15 South Steyne||Manly||NSW||2095|
|Dr Peter Davidson||02 9819 6666||159 Victoria Road||Drummoyne||NSW||2047|
|Dr Philip Georgoures||02 9663 1581||157 Anzac Parade||Kensington||NSW||2033|
|Dr Russell Spinks||02 4328 2811||100 Narara Valley Drive||Narara||NSW||2251|
|Dr Timothy David||02 9427 4855||175 Burns Bay Road||Lane Cove||NSW||2066|
|Dr Tocker||9399 6327 9389 8081||155 Belmore Road||Randwick||NSW||2031|
|Dr Tom Rosenthal||95253464||Suite 3, 32-36 Urunga Pde||Miranda||NSW||2228|
|Dr Yun Teoh||02 9436 4021||1A/375 Pacific Hwy||Crows Nest||NSW||2065|
|Dr. Jyothi Reddy||02 9878 6666||Shop 45, Macquarie Shopping Centre, 197 Herring Rd||North Ryde||NSW||2113|
|Dr. Leigh Barlow||02 8313 2999||Level 1, 147-151 Redfern Street||Redfern||NSW||2016|
|Dr. Michael Bonning||02 9575 4111||275 Darling Street||Balmain||NSW||2041|
|Dr. Peter Saxon-Williams||02 8914 8080||18-20 Park Street||Mona Vale||NSW||2103|
|Dr. Richard Loizou||02 9922 3022||Shop 2, 51 Berry Street||North Sydney||NSW||2060|
|Dr. Robert Micallef||02 9231 3211||308 George St||Sydney||NSW||2000|
|Merewether||02 4929 2718||147 Darly Street||Merewether||NSW||2291|
|Miranda Medical Centre||95401044||573 Kingsway||Miranda||NSW||2228|
|Nelson Bay Medical Centre||02 4981 1722||Stockton Street Cnr Tomaree St||Nelson Bay||NSW||2315|
|Port Stephens Medical Centre||02 4981 1733||2 Keel St||Salamander Bay||NSW||2317|
|Warringah||(02) 9938 6666||10 Dale Street||Brookvale||NSW||2100|
|Cairns 24 hrs Medical Centre||61 7 40521119||Cnr Florence & Grafton St||Cairns||QLD||4870|
|Dr Ben Powell||07 3268 1566 / 3268 1567||79 Racecourse Rd||Ascot||QLD||4007|
|Dr Jadon Ting||(07) 3341 2022||2/48-54 Koobil Street||Rochedale South||QLD||4123|
|Dr Margaret McAdam||07 3221 3366||289 Queen Street||Brisbane||QLD||4000|
|Dr Meehan||61 7 4052 1583||67 McLeod Street||Cairns||QLD||4780|
|Dr Peta Leonard||07 3229 9209||Level 1, 10 Market St||Brisbane||QLD||4000|
|Dr Peter Friis||07 3834 6635||259 Wickam Terrace||Brisbane||QLD||4000|
|Dr Tara Parsons||07 3412 7777||Main Street||Beenleigh||QLD||4207|