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SCUBA Diver Medical Examination Form 2026
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- Click ‘Get Form’ to open the SCUBA Diver Medical Examination Form in the editor.
- Begin by filling out Part I, Diver Medical History. Enter your name, contact information, date of birth, height, weight, sex, age, and eye color. Ensure all fields are completed accurately.
- Check all applicable medical history boxes related to persistent headaches, emotional problems, and any other conditions. If you check any boxes, provide explanations in the designated area.
- Complete the emergency contact section with the name, relationship, and contact details of your emergency contact.
- Sign and date the form at the bottom of Part I to confirm that all information is correct.
- In Part II, Diving Fitness Examination, ensure your physician fills out their details and comments on your fitness for diving based on their examination.
- Review all sections for completeness before saving or exporting your filled form for submission.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2003 | 3.9 Satisfied (40 Votes) |
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Related links
In addition to the Report of Medical History Diver, provide the examiner a NOAA Form 57-03-51, Report of Physical Examination Diver. Use NOAA Form 57-03Read more
Medical Evaluation of Fitness for Scuba Diving Report. Diving Medical History Form. Page 6. APPENDIX B: MEDICAL EXAMINATION FORM. 6. APPENDIX B. 3. MEDICALRead more