Home

About

Advanced Search

Browse by Discipline

Scientific Societies

E-print Alerts

Add E-prints

E-print Network
FAQHELPSITE MAPCONTACT US


  Advanced Search  

 
MEDICAL EVALUATION OF FITNESS FOR SCUBA DIVING REPORT Name of Applicant (Print or Type) Date(Mo/Day/Year)
 

Summary: APPENDIX 2
MEDICAL EVALUATION OF FITNESS FOR SCUBA DIVING REPORT
____________________________ _______________
Name of Applicant (Print or Type) Date(Mo/Day/Year)
To The PHYSICIAN:
This person is an applicant for training or is presently certified to engage in diving with self- contained
underwater breathing apparatus (scuba). This is an activity which puts unusual stress on the individual in
several ways. Your opinion on the applicant's medical fitness is requested. Scuba diving requires heavy
exertion. The diver must be free of cardiovascular and respiratory disease. An absolute requirement is the
ability of the lungs, middle ear and sinuses to equalize pressure. Any condition that risks the loss of
consciousness should disqualify the applicant.
TESTS: Please initial that the following tests were completed.
[ ] Initial Examination [ ] Re-examination (Every 5 years under age
40, or first exam over age 40, every 3 years over
age 40, every 2 years over age 60)
_____ Medical History _____ Medical History
_____ Complete Physical Exam with emphasis _____ Complete Physical Exam, with emphasis
on neurological and otological components on neurological and otological components
_____ Chest X-Ray
_____ Spirometry _____ Hematocrit or Hemoglobin

  

Source: Arslan, Hüseyin - Department of Electrical Engineering, University of South Florida

 

Collections: Engineering