Diver Medical Questionnaire: When You Need a Doctor's Sign-Off

Do you need a medical to scuba dive?

Most new divers do not. The Diver Medical Participant Questionnaire is a self-screening form that you complete as a prerequisite to a recreational scuba or freediving course. If you answer no to all 10 questions on page 1, the form states that a medical evaluation is not required: you sign the participant statement and hand it to the dive center. Certain yes answers change that, and then a physician has to sign the third page before you dive.

The form is designed mainly as a first screen for new divers, but it describes itself as appropriate for anyone considering any diving activity, and the UHMS guidance for physicians says it is endorsed by the majority of diver training organizations. Local practice can differ. A 2015 study noted that diving medicals have not been mandatory for UK sport divers since 2001; they submit an annual medical self-certification form to their club or training establishment instead.

This page explains how the screening works. It is general information, not medical advice, and it cannot tell you whether you are fit to dive. Only a physician can do that. Related articles are collected in our safety guides.

Which version of the diver medical form is current?

The current English form carries the version date 2026-01-01, printed at the bottom of page 1. It replaced the version dated 2022-02-01. The UHMS download page offers the form in 30 languages, and not every translation carries the newest date, so check the version date printed on the one you use. Others, including the Japanese, Portuguese and Thai forms, were still 2021 or 2022 versions, so check the date on the copy your dive center gives you.

The form was written by the Diver Medical Screen Committee (DMSC), an independent international group of diving medicine experts brought together in 2017. In the UHMS's words, after almost 30 years there was enough evidence to support a revision. The new questionnaire was field tested for efficacy and screening sensitivity and published in June 2020. It was created in association with the Undersea and Hyperbaric Medical Society (UHMS), DAN (US), DAN Europe and the Hyperbaric Medicine Division of the University of California, San Diego. A subgroup of the committee reviews user comments and revises the form and the physician guidance when needed. The 2026 changes are small but can change your answers.

Which yes answers mean you need a doctor?

Page 1 has 10 yes/no questions, and they work in two ways. Questions 3, 5 and 10 send you straight to a doctor if you answer yes. The other seven are gateways: a yes sends you to a lettered box on page 2 with narrower questions, and only a yes inside that box makes the medical evaluation mandatory.

So being over 45 does not, by itself, mean a medical. It means you answer the four questions in box B. An old ear problem or back injury works the same way, because the follow-up boxes ask whether it is recent or still limiting you. Box C, for example, asks about sinus surgery in the last 6 months and eye surgery in the last 3 months.

The form also carries a note to women: if you are pregnant or trying to become pregnant, do not dive.

Over 45: what box B asks and why

If you are over 45, box B asks four things: whether you smoke or inhale nicotine by other means, have high cholesterol, have high blood pressure, or have a close blood relative who died suddenly or of heart disease or stroke before 50 (or a family history of heart disease before 50). One yes means a physician's approval. The UHMS FAQ defines close blood relatives as biological parents, grandparents and siblings.

The reason is the heart. The physician guidance notes that almost 30% of recreational diving fatalities have a cardiac event as the disabling injury, because immersion loads the heart, narrowing of blood vessels in the skin and limbs raises blood pressure, and the diver is usually exercising at the same time. It advises that people over 45 with coronary risk factors be evaluated even without symptoms, and that anyone with a predicted 5-10 year cardiovascular risk above 10% on a risk calculator be investigated for coronary disease, unless they give a credible history of exercise capacity. A coronary calcium score is suggested as a first test.

The fitness target is concrete. The guidance calls sustained exercise at 6 METs, about six times resting metabolic rate, a pragmatic expectation for a recreational diver, with occasional short bursts above that. A consensus paper from a DAN fatality workshop put the matching peak capacity at 11-12 METs and named the exercise stress test as the tool of choice for candidates with coronary risk factors. Fatality figures by age are in our article Is scuba diving dangerous?

What to take to the doctor

Take the whole form, not only the signature page. The questionnaire tells you to bring all three pages, and the UHMS FAQ adds the Diving Medical Guidance, a free document written for the examining physician.

• All three pages of the questionnaire, with page 1 signed and dated. Page 3 is the Medical Examiner's Evaluation Form.
• The Diving Medical Guidance to the Physician (current version 2023-05-31) from the UHMS website. It sorts conditions into severe, relative and temporary risk and gives references, which helps a doctor who rarely sees divers.
• Recent records for whatever you answered yes to, such as test results or a specialist's letter. The guidance says diagnostic studies and specialist consultations should be obtained as indicated, so the doctor may still order tests.
• Time for an in-person visit if the question is about your heart or lungs. The FAQ says telemedicine can work for some topics, but heart and lung disease, where an ECG, chest X-ray or lung function test may be needed, warrant seeing the doctor in person.

What the doctor's page says, and who gets to see it

Page 3 has two possible results: Approved, meaning the doctor finds no conditions incompatible with recreational scuba diving or freediving, or Not approved. There is no comments box. The committee removed it on purpose, and the form warns that extra commentary can make it invalid for some agencies. Advice about limits can go in a separate note or letter.

Only that page has to go back to the dive center. It shows your name, birth date and the decision. Your answers on pages 1 and 2 stay with you and the doctor, a split the committee designed to protect medical confidentiality.

Who signs matters if you train abroad. The UHMS FAQ says some US jurisdictions allow nurse practitioners or physician assistants to sign diving clearances, but in most countries only physicians are recognized, so a non-physician signature may not be accepted outside the US.

Common reasons people get referred

A yes is not a ban. It asks a physician to judge how well a condition is controlled. The guidance groups conditions as severe risk (its authors would generally discourage diving), relative risk (a decision about the individual) and temporary risk (diving can resume once the problem has resolved).

Referrals were common under the older form. In a Hong Kong study of 117 people completing the Chinese version of the previous RSTC medical statement, only 28.2% answered no to every question. Cutting physician visits for problems that are resolved or unlikely to affect diving safety was one of the stated goals of the 2020 revision. The table summarizes how the physician guidance treats some frequent reasons for a yes. If ears or sinuses are the issue, our guide on how to equalize your ears covers the diving side.

How to find a dive medicine doctor

Any physician can sign the form, but one trained in diving medicine will know which tests matter. If your own doctor is willing but unsure, the UHMS FAQ says they can discuss your case with DAN free of charge. These are the directories the diving medicine bodies publish:

• DAN Physician Referral Network: a worldwide network of doctors trained in dive medicine. Call +1 919 684 2948 (Monday to Friday, 8:30 a.m. to 5 p.m. US Eastern time) or use DAN's online Ask a Medic form. DAN says the network has more than 600 physicians. This line is for fitness-to-dive questions; emergencies go to the DAN Emergency Hotline.
• UHMS Physician Diver Assessment List: includes a list of physicians trained in diving medicine or board certified in undersea medicine who assess recreational scuba divers and freedivers.
• SPUMS Diving Doctors List: searchable by area, mostly Australia with some doctors elsewhere in Asia, and shows which kinds of dive medicals each doctor performs.
• UK Diving Medical Committee Medical Referees: a searchable list of referees across the UK, with a few abroad.

Answer honestly, and do it before the trip

DAN says it receives too many accident reports in which the diver left something off the medical statement, and that omissions can delay the right treatment as well as put the buddy at risk. Its advice is to download the form and complete it well before travelling, then see a physician about any yes answer before leaving. Instructors, divemasters and shop staff are not physicians and should not be asked for medical advice.

Surveys of experienced divers show why the form matters later in a diving life too. In a survey of 346 experienced Australian club divers published in 2002, 13% needed regular medication, 10.4% reported asthma and the same share reported hypertension or coronary heart disease. In a 2015 survey of 672 UK sport divers, 18% reported hypertension and 21% of those had never had a diving medical. The committee's FAQ puts it plainly: the value of the form depends on honest and correct answers.