Medical Questionnaire for Scuba Diving 


Welcome to our Scuba Diving and Snuba medical history questionnaire. Your safety is our top priority, and this questionnaire is designed to ensure that participating in recreational scuba diving is suitable for you. A positive response to any of the following questions does not automatically disqualify you from diving. However, it indicates the presence of a preexisting condition that may impact your safety, and consulting with a physician is crucial.


Ear Health:

Do you currently have an ear infection?
Do you have a history of ear disease, hearing loss, or problems with balance?
Have you undergone ear or sinus surgery?

Respiratory System:

Are you currently suffering from a cold, congestion, sinusitis, or bronchitis?
Do you have a history of respiratory problems, severe hayfever or allergies, or lung disease?
Have you experienced a collapsed lung (pneumothorax) or had chest surgery?

Asthma and Medication:

Do you have active asthma or a history of emphysema, tuberculosis, or other lung conditions?
Are you currently taking medication with warnings about impairment of physical or mental abilities?

Behavioral and Nervous System:

Do you have behavioral health problems or a nervous system disorder?

Pregnancy and Other Conditions:

Are you currently pregnant or could you be pregnant? Do you have a history of colostomy?

Have you experienced heart-related conditions, including heart attack, surgery, or blood vessel surgery?

Do you have a history of high blood pressure, angina, or take medication for blood pressure control?

If you are over 45, do you have a family history of heart attack or stroke?

Do you have a history of bleeding or other blood disorders?

Have you been diagnosed with diabetes?

Neurological and Musculoskeletal:

Do you have a history of seizures, blackouts, fainting, convulsions, epilepsy, or take medications to prevent them?

Do you have a history of back, arm, or leg problems following an injury, fracture, or surgery?

Psychological Conditions:

Do you have a history of fear of closed or open spaces or panic attacks (claustrophobia or agoraphobia)?
Remember, a positive response means there is a preexisting condition that may affect your safety while diving.


It is essential to seek the advice of a physician if any of these items apply to you before participating in scuba diving.


Your well-being is our priority, and we want to ensure you have a safe and enjoyable experience exploring the underwater world.





TEL: (808) 256-8956




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CANCELLATION POLICY: A minimum of 48 hours notice is required to cancel any reservation. A full refund will be paid on any reservation canceled prior to this minimum notice. In the event of dangerous weather or ocean conditions, we may cancel your tour, you may choose to transfer your activity to a later date or receive a full refund.