Diver Medical | Participant Questionnaire
All questions are required fieldsComplete this questionnaire as a prerequisite to a recreational scuba diving or freediving course.
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, listed below. Those who have, or are predisposed to, any of these conditions, should be evaluated by aphysician. This Diver Medical Participant Questionnaire provides a basis to determine if you should seek out that evaluation. 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. References to “diving” on this form encompass both recreational scuba diving and freediving. This form is principallydesigned as an initial medical screen for new divers, but is also appropriate for divers taking continuing education. For your safety,and that of others who may dive with you, answer all questions honestly.
If you answered NO to all 10 questions above and did not have to answer any questions from boxes A-G, a medical evaluation is not required. Please read and agree to the participant statement below by signing in the last step.
Participant Statement: I have answered all questions honestly, and understand that I accept responsibility for any consequences resulting from any questions I may have answered inaccurately or for my failure to disclose any existing or past health conditions.
* If you answered YES to questions 3, 5, or 10 OR to any of the questions in boxes A-G, please read the statement
AND take all three pages of this form (Candidate Questionnaire and Medical Evaluation Form) to your physician for a medical evaluation. Your physician's approval is required to participate in a diving course.
Statement of Risk and Liability/Non-agency Acknowledgment Form (EU Version)
Non-Agency Disclosure and Acknowledgment Agreement
I understand and agree that PADI® Members (“Members”), including Ocean Trek Dive Center and/or any individual PADI Instructors and Divemasters associated with the program in which I am participating, are licensed to use various PADI Trademarks and to conduct PADI training, but are not agents, employees or franchisees of PADI EMEA Ltd., PADI Americas, Inc., or its parent, subsidiary and affiliated corporations (“PADI”). I further understand that Member business activities are independent, and are neither owned nor operated by PADI, and that while PADI establishes the standards for PADI diver training programs, it is not responsible for, nor does it have the right to control, the operation of the Members’ business activities and the day-to-day conduct of PADI programs and supervision of divers by the Members or their associated staff.
Statement of Risk and Liability
This is a statement in which you, the certified diver, or a student diver under the control and supervision of a certified scuba instructor, are informed that skin diving, freediving and scuba diving have inherent risks, including those risks associated with boat travel to and from the dive site. The statement also sets out the circumstances in which you participate in the diving experience at your own risk. Your signature on this statement is required as proof that you have received, read and understood this statement. It is important that you read the contents of this statement before signing it. If you do not understand anything contained in this statement, then you should discuss it with your instructor. If you are a minor, this form must also be signed by a parent or guardian.
Warning
Skin diving, freediving and scuba diving have inherent risks which may result in serious injury or death.
Diving with compressed air involves certain inherent risks; decompression sickness, embolism or other hyperbaric injury can occur that require treatment in a recompression chamber. Risks also include slipping or falling while on board a boat, if one is used, being cut or struck by a boat while in the water, injuries occurring while getting on or off a boat, and other perils of the sea. Open water diving trips that may be necessary for this experience may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber. Skin diving, freediving and scuba diving are physically strenuous activities and you will be exerting yourself during this diving experience. Past or present medical conditions may be contraindicative to your participation in this experience. You must be in good mental and physical fitness for diving, and not under the influence of alcohol, nor any drugs that are contraindicatory to diving. If you are taking medications, you affirm that you have seen a physician and have approval to dive under the influence of the medications/drugs. You must inspect all of your equipment prior to this experience and notify the dive professionals and the facility through which this experience is offered if any of your equipment is not working properly. If diving from a boat, you must be present at and attentive to the briefing given by the boat crew. If there is anything you do not understand you will notify the boat crew or captain immediately. You must follow safe dive practices and plan dives as no-decompression dives and within parameters that allow a safety stop before ascending to the surface, arriving on board the vessel with gas remaining in your cylinder as a measure of safety. If distressed on the surface, you must immediately drop your weights and inflate your BCD (orally or with the low pressure inflator) to establish buoyancy on the surface. If a Guide is present to assist during the dive, and you choose to dive with the Guide, it is your responsibility to stay in proximity to the Guide during the dive.
Acceptance of Risk
I understand and agree that neither the dive professionals conducting this program, Employees of Ocean Trek Dive Center, or the facility through which this program is conducted, Ocean Trek Dive Center, or PADI EMEA Ltd., or PADI Americas, Inc. or their affiliate or subsidiary corporations, or any of their respective employees, officers, agents, contractors or assigns accept any responsibility for any death, injury or other loss suffered by me to the extent that it results from my own conduct or any matter or condition under my control that amounts to my own contributory negligence.
In the absence of any negligence or other breach of duty by the dive professionals conducting this program, Employees of Ocean Trek Dive Center, the facility through which this program is offered, Ocean Trek Dive Center, ADI EMEA Ltd., PADI Americas, Inc. and all parties referred to above, my participation in this diving program is entirely at my own risk.
I hereby acknowledge that I have received this Agreement of Notice and Acknowledgement of Non-Representation and Statement of Risks and Liability and have read all clauses before signing.
Important
Please do not sit in the car with wet swimwear after diving! Take dry clothes for each dive to change. Do not take valuables in the car! Here on Tenerife cars are regularly broken into.
Playa de las Americas - Troviscas / Costa Adeje - Santa Cruz de Tenerife | 16. April 2025