S2CLUB SAIPAN Medical check list

Medical check list

Medical check list for diving
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1Could you be pregnant, or are you attempting to become pregnant ?
2Are you presently taking prescription medications ? (with the exception of birth control or anti-malaria)
3Asthma, or wheezing with breathing, or wheezing with exercise ?
4Any form of lung disease, pneumothorax(collapsed lung), other chest disease or chest surgery ?
5Epilepsy, seizures, convulsions or take medications to prevent them ?
6High blood pressure or take medicine to control blood pressure ?
7Heart disease, or heart attack, Angina, or any heart surgery or blood vessel surgery, bleeding or other blood disorders ?
8Ulcers or ulcer surgery ?
9A colostomy or ileostomy ?
10Any problems following surgery, injury or fracture ?
11Behavioral health, mental or psychological problems (panic attack, fear of closed or open spaces) ?
12Any dive accidents or decompression sickness ?
13Sinus sergery, ear disease or surgery hearing loss or problems with balance ?
14Frequent or severe attacks or hayfeber or allergy ?
15Frequent or severe suffering from motion sickness (seasick, carsick, etc.) ?

Are you over 45 years of age and can answer YES to one or more of the following ?

16currently smoke a pipe, cigars or cigarettes ?
17have a high cholesterol level ?
18have a family history of heart attack or stroke ?
19are currently receiving medical care ?
20high blood pressure ?
21diabetes mellitus, even if controlled by diet alone ?

Any questions or concerns, please let us know !

Our staff will get back to you within 24 hours.