Medical Questionnaire

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The purpose of the Medical Questionnaire is to find out if you should be examined by your doctor before participating in recreational scuba 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 prior to engaging in dive activities.

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If you answer "Yes" to any of the following questions, please contact Amanda mobile 0419 201 504

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1. Have you had problems with my lungs/breathing, heart, blood, or have been diagnosed with COVID-19

2. Could you be pregnant, or attempting to get pregnant?

3. Are you presently taking prescription medication? (with exception of birth control pills)

4. Are you over the age of 45 years of age and can answer YES to one of the following? ​​

• currently smoke a pipe, cigars or cigarettes

• have a high cholesterol level

• have a family history of heart attacks or stroke

• are currently receiving medical care

• high blood pressure

• diabetes melitius, even if controlled by diet

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Have you ever had or do you currently have ...

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1. Asthma, or wheezing with breathing, or wheezing with exercise?

2. Frequent or severe attacks of hayfever or allergy?

3. Frequent colds or bronchitis?

4. Any form of lung disease?

5. Pneumothorax (collapsed lung)?

6. Other chest disease or chest surgery?

7. Behavioural health, mental or psychological problems (Panic attack, fear of closed or open spaces)?

8. Epilepsy, seizures, convulsions or take medication to prevent them?

9. Recurring complicated migraine headaches or take medications to prevent them?

10. Blackouts or fainting (full/partial loss of consciousness)?

11. Frequent or severe suffering from motion sickness (seasick, carsick ect.)?

12. Dysentery or dehydration requiring medical intervention?

13. Any dive accidents or decompression sickness?

14. Inability to perform moderate exercise (example. walk 1.6km within 12 minutes)

15. Head Injury with loss of consciousness in the past five years?

16. Recurrent back problems?

17. Back or spinal surgery?

18.  Diabetes?

19. Back, arm or leg problems following surgery, injury or fracture?

20. High blood pressure or take medicine to control blood pressure?

21. Heart Disease?

22. Heart Attack?

23. Angina, heart surgery or blood vessel surgery?

24. Sinus surgery?

25. Ear disease or surgery, hearing loss or problems with balance?

26. Recurrent ear problems?

27. Bleeding or other blood disorders?

28. Hernia?

29. Ulcers or ulcer surgery?

30. A colostomy or ileostomy?

31. Recreational drug use or treatment for, or alcoholism in the past five years?

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If you have answered "Yes" to any of the questions above, we must request that you contact Amanda and she will provide you will the "RSTC Medical Statement and Guidelines for Recreational Scuba Diver's Physical Examination" form to be taken to your physician to be signed prior to starting any scuba diving activities.