Home
Forms Library
Ns medical screening questionnaire

Medical screening questionnaire 2025

ns medical screening questionnaire Preview on Page 1

See details

4.4 out of 5

80 votes

The document is a Diver/BUD/S Medical Screening Questionnaire from the U.S. Coast Guard, designed to assess the medical fitness of individuals applying for diving duty. It includes a series of medical questions regarding past health issues, physical conditions, and psychiatric evaluations that must be answered truthfully. The questionnaire emphasizes the importance of disclosing any medical history, as concealment may lead to disqualification. Additionally, it outlines requirements for medical examinations and waivers necessary for diving candidates.

Here's how it works

01. Edit your ns medical screening questionnaire online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send medical health screening questionnaire via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out medical screening questionnaire with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Diver/BUD/S Medical Screening Questionnaire in the editor.
Begin by filling in your personal information, including Name/Rank, EmplID, DOB, Present Command, and Branch of Service. Ensure accuracy as this information is crucial for identification.
Proceed to the Diving Medical Questions section. For each question, select 'Yes' or 'No' based on your medical history. If you answer 'Yes' to any question, be prepared to provide additional details later in the form.
Complete the Additional Diving Medical Questions section as required. This part may involve input from a Diving Medical Officer (DMO) or qualified representative.
Review all entries for completeness and accuracy before submitting. Use our platform’s features to save your progress and make edits as needed.

Start filling out your medical screening questionnaire online for free today!

See more medical screening questionnaire versions

We've got more versions of the medical screening questionnaire form. Select the right medical screening questionnaire version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2019	4.9 Satisfied (21 Votes)
2010	4.4 Satisfied (80 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a medical screening questionnaire?

The Medical Screening Questionnaire will include questions related to your personal and family medical history, drug allergies and more. Filling up this form accurately is important for our Medical Officers to determine your fitness for NS, and to consider your medical condition(s) during NS training.

What does a medical screening exam consist of?

Measure your height and weight. Check your vital signs. Review your medical history and family medical history. Identify what medications or supplements you currently take.

What does a health screening questionnaire look like?

The survey consists of four sections, including personal information, lifestyle, medical history, and mental health. The questionnaire includes a mix of answer types, such as multiple choice and select-all-that-apply, and is split into different sections for ease of completion.

What are screening questionnaires?

A screening question filters out respondents whose responses are relatively less valuable while helping you receive responses from those you value most.

Try more PDF tools