Introductory Dive
Statement of health and expectation coordination

Dear participants,
In order to maintain your health and ensure your insurance and enjoyment during the activity, please read carefully the medical statement before you and the stresses related to the activity:

Medical information

If you have suffered from any of the following conditions, please indicate this in the form:
In case of doubt, please consult us.

Asthma or other respiratory or past respiratory problems

Yes No

Past and present ear problems

Yes No

Sinus problems

Yes No

High blood pressure or low blood pressure

Yes No

A heartfelt event in the past

Yes No

Epilepsy

Yes No

Diabetes mellitus

Yes No

Recent surgery or illness

Yes No

Chronic disease

Yes No

Claustrophobia

Yes No

Mental problem or limitation

Yes No

Taking medication regularly

Yes No

Traffic restriction or functional problem

Yes No

Introductory DiveStatement of health and expectation coordination

Medical information

Introductory Dive
Statement of health and expectation coordination