At the beginning of every scuba class, students are required to fill out a Medical History Questionnaire. This questionnaire is part of a larger document called the Medical Statement, and this Statement was created by the RSTC (Recreational Scuba Training Council) and is widely used among U.S. scuba training agencies. The purpose of the Medical History Questionnaire is to find out if the diver should be examined by a physician before beginning scuba training. So why post an article on how to fill out the form? Well, over the years as an instructor trainer, dive training agency director, and a forensic diving accident investigator, I have seen countless examples of how the improper use of this form has been extremely harmful (even fatal) to multiple individuals impacted by it. Both new and seasoned divers, as well as all diving professionals, need to know how important this form is for their own well-being, and the well-being of their instructors, divemasters, students, and dive buddies.
Here are the steps for properly filling out this extremely important document:
Step 1: Be Truthful – The questionnaire asks if you have had at any time a condition within the list of medical conditions. If so, you will give a positive response (“YES” answer) to the condition noted. A positive response to a question does not necessarily disqualify you from diving. Rather, it shows that there is a pre-existing medical condition that may affect your health and safety when diving with compressed air under varying states of pressure. Thus, a physician is called upon to examine your ability to proceed with the scuba training or not.
But here is where people get into trouble. The diver is on vacation and wants to take a scuba course. He signs up for the course which starts that night. Upon arriving at the course he fills out the paperwork and the instructor notices a “YES” response to the line “Asthma, or wheezing with breathing, or wheezing with exercise”. This form now requires a physician’s approval for the individual to continue in the course. But, how will that happen when it is late afternoon or on a weekend? Here are the things that go wrong:
- The diver decides that the episode was when he was a child so he crosses the YES out an writes a NO. WRONG! The diver had the condition, even as a child, so it must be noted.
- The instructor recognizes she will lose this diver’s registration in her class and decides to inquire about the condition and whether or not it should really be given a YES. The instructor finds out the asthma occurred in childhood, and concludes that the diver is fine. She rips up the form and tells the diver to fill it out again, this time with a NO in the Asthma line. WRONG! The diving instructor or divemaster is not the physician of the diver, and cannot make a call on a medical condition – only a physician can.
Step 2: Be Accurate – The Medical Statement can be inaccurate when improperly filled out. It is important to write the actual words “YES” or “NO” on the Medical History Questionnaire. Simply writing a “N” or “Y” or even a “–” is not acceptable. Nor can you write one word and then draw a straight line down the list to in an attempt to include all (see examples).
Also be sure to fill in every other area a) legibly and b) in detail. Be as accurate as you can about your physician, or even past physician if you no longer live in the same location and have not seen a new physician.
Sign and date the form properly.
Step 3: Be Willing to Get a Physician’s Signature – As mentioned in step 1, some people have lied on their diving Medical Statement to forgo obtaining a physician’s signature. This can have drastic consequences – don’t do it! If you have a “YES” response to ANY of the items in the Medical History Questionnaire you have a couple options:
- Fax the form in its entirety to your physician and ask if he or she will approve you to dive. If your physician has regularly seen you for checkups and can pull your medical file and review it, chances are your physician will select the appropriate box, sign it, and fax the forms back to you.
- Go see your physician. You can either go see your physician or go see a new one if you currently don’t have one. Bring all six pages of the Medical Statement with you. You will be given a routine check, with perhaps more of a focus on airway, ears, sinuses, and lungs. This is not generally a Diving Physical Exam – those are more formal and used often for military, commercial, and/or scientific diving purposes. After your examination your physician will select the appropriate box, sign it, and hand you the forms.
A note on physicians reviewing your eligibility to dive – not all physicians understand the myriad of medical complexities surrounding diving with compressed air in varying pressure environments. If the physician is a diver, it does not qualify the physician in the areas of Diving Medicine or Hyperbaric Medicine. However, physicians who are divers may have an increased understanding of the items to consider for healthy diving. In either case, the last four pages of the Medical Statement are called the “Guidelines for Recreational Scuba Diver’s Physical Examination” and is for the physician to use in determining divers’ medical fitness for scuba diving. These guidelines help a physician ascertain whether a certain medical condition is a relative risk, a temporary risk, or a severe risk condition in diving. Make sure the physician has all four pages of the guidelines.
You could also seek a physician with specialized knowledge of diving. One of the best resources for this is through the Divers Alert Network (DAN) Physician Referral Network. If you are looking for a physician to conduct a diving physical or would like a consultation from a diving medical specialist in your area simply go to http://www.diversalertnetwork.org/medical/network/physician.
Bottom line: There is nothing underwater worth risking your life to see. Be truthful and accurate on your Medical History Questionnaire.
