Dr. Adam’s Ultimate Guide to the Scuba Diving Medical in 2026

I’m Dr. Adam Z. Kawalek, a board-certified internist and a PADI certified diver. I’ve logged dives in Belize, Hawaii and Bali, and like every certified diver, I started with a version of the same medical questionnaire you’re probably looking at right now. I also evaluate divers for that exact form, so I see where people get stuck from both sides of the paperwork.

Most of the trouble has nothing to do with anyone’s health. It comes from misreading the form, finding out late that a signature is needed, or leaving the whole thing until the week of the trip. This guide is the practical version: what the dive medical is, when you need a doctor, how to plan around it, and the mistakes worth avoiding. If you only want the headline version, it’s in the next section.

The short answer

• If you answer no to all ten questions on the diver medical questionnaire, you sign it and you do not need a doctor.
• Certain yes answers mean a physician has to evaluate you and approve you before your course.
• The result is approved or not approved. There is no maybe.
• PADI’s guidance to instructors is that a fit-to-dive medical must still be less than one year old when your course is completed.
• Start early, answer honestly, and read the exact requirements your dive shop or boat sends you.
• The same form applies to try dives, to kids, and to certified divers starting a new course.

What a dive medical is, and why it exists

The dive medical is really two documents. The first is the Diver Medical Participant Questionnaire, which you fill out yourself. The second is the evaluation form a doctor completes, and it only comes into play if your answers call for it.

The questionnaire was created by the Diver Medical Screen Committee in association with the Undersea and Hyperbaric Medical Society, DAN in the US, DAN Europe and the hyperbaric medicine division at the University of California, San Diego. The system was overhauled in 2020, and the current version of the form is dated February 2022. PADI, SSI, NAUI and most other recreational training agencies use it, and you can read the official form on PADI’s site.

The form explains its own purpose in its first line: “Recreational scuba diving and freediving requires good physical and mental health.” It goes on to say that a few medical conditions can be hazardous while diving, and that its job is to help you decide whether you should be evaluated by a physician first. A few other details are worth knowing:

• It covers freediving as well as scuba.
• It’s designed mainly as a first screen for new divers, but it’s also used for continuing education courses.
• It tells you that if you’re feeling ill, you should avoid diving, and that if you think you may have a contagious illness, you should stay out of training and dive activities.

It’s worth being clear about what the form isn’t. It isn’t a swim test, since your course has its own water skills requirements. It isn’t a guarantee that diving is risk free for anyone. And it isn’t a commercial or occupational diving medical, which work under separate standards. It’s a screening tool for recreational divers, and a good one.

How the form works, and the questions people trip on

The first page has ten yes or no questions. They cover your lungs and heart, your age, your ability to exercise, your ears and sinuses, recent surgery, neurological history, mental health, back problems and diabetes, stomach problems, and prescription medications.

If you answer no to all ten, the form says it plainly: “a medical evaluation is not required.” You sign the participant statement, hand it to your instructor, and you’re done.

If you answer yes, what happens next depends on the question. A yes to the questions about exercise capacity, recent surgery or prescription medications sends you straight to a physician. A yes to any of the other questions sends you to a short follow-up box on the second page, and a yes inside that box is what requires an evaluation. The form is laid out so that a broad yes gets narrowed down before anyone needs a doctor. If you want to go through it question by question, I’ve written a walkthrough of the diver medical questionnaire.

The ten questions at a glance

Here’s how the first page routes you. The topics below are summarized from the form itself.

A yes to any item inside a follow-up box also means a physician evaluation. A no to everything in a box means that question doesn’t require one.

These are the spots where I see people misread it most:

• Being over 45 doesn’t, on its own, require a doctor. It sends you to a follow-up box that asks whether you smoke or inhale nicotine by other means, have high cholesterol or high blood pressure, or have a family history of heart disease or sudden death before 50. A yes to any of those does require an evaluation. Vaping nicotine counts as inhaling it.
• Birth control doesn’t count as a prescription medication on this form. Neither do antimalarial drugs, with one named exception, mefloquine (Lariam).
• Some yes answers surprise people. Frequent heartburn is on the form. So are hay fever and allergies, if they have limited your exercise in the past year.
• The time frames matter. Several questions ask about the past year, and some about the past five years, not just how you feel today. Read the window in each one before you answer.
• The form gives one instruction directly. If you’re pregnant or trying to become pregnant, it says not to dive.

Whatever you answer, answer it honestly. When you sign, you’re agreeing to the participant statement, which says you accept responsibility for the consequences of any question you answered inaccurately or any condition you failed to disclose. The form exists to catch problems that are much easier to deal with on land.

When you’ll need a signature even with a clean form

A clean questionnaire doesn’t always mean you’re finished. Two common situations call for a physician’s signature anyway.

The first is the operator. Some dive operators, liveaboards and resorts ask every diver for a physician-signed medical, regardless of how the questionnaire came out, and some use their own forms. If your booking confirmation mentions a medical, read the exact wording before you assume the questionnaire covers it.

The second is professional training. PADI requires Divemaster, Assistant Instructor and other professional-level candidates to be medically evaluated and cleared for diving by a physician within 12 months, whatever their answers. If you’re going pro, plan the medical into the timeline from the start.

Going on a try dive? The same rules apply

A lot of people meet the dive medical for the first time on vacation, at a resort pool or on a shore excursion, when they sign up for a one-day introductory dive. Those programs go by names like PADI’s Discover Scuba Diving or SSI’s Try Scuba, and they use a medical questionnaire too. The operator will ask you to complete it before the session, and if you answer yes to a question that calls for a physician, you’ll need a signed approval from a doctor before you can get in the water. Without it, the instructor isn’t allowed to take you.

That catches travelers off guard, because they find out on the morning of the excursion, far from their own doctor. A few habits prevent it:

• Ask the operator to send the form ahead of time. Cruise excursion listings sometimes spell out the medical requirement, but don’t count on it.
• Read it at home, not at the dock. If every answer is no, you’re set. If anything is a yes, you have time to get it signed before you travel.
• Treat a try dive like a course. The dive is only one day, but the paperwork stakes are the same.

Already certified? Check before you book

Your certification card doesn’t expire, but a medical approval does, and the two get confused. Being certified tells an operator you’ve been trained. It doesn’t tell them anything about your health today.

The questionnaire is built with this in mind. It’s meant mainly for new divers, but it’s also used for continuing education, so expect to fill it out again when you sign up for your next course. Some liveaboards and dive operators also ask certified divers to complete a medical questionnaire before a trip, and some have their own versions written for certified divers.

The honest test is simple. If anything has changed since you last filled it out, such as a new surgery, a new prescription or a new diagnosis, your old answers no longer describe you, and an old approval doesn’t cover the change. Fill it out again, and if a yes calls for a physician, get the evaluation before you go.

Diving with kids

Kids use the same questionnaire as adults, and the same routing applies. The difference is the signature. For a minor, the form requires a parent or guardian to sign the participant statement.

For PADI, the entry point is the Junior Open Water Diver course, which starts at age 10. Each training agency sets its own minimum ages for each program, so check with your shop before you book.

A few things make it smoother:

• Fill it out together. A parent usually knows the past surgeries, medications and medical history better than a ten-year-old does.
• If there’s a yes, start with your pediatrician. They know your child’s history and are a natural first call.
• Check age limits on any online service. Some online evaluation services only see adults, so confirm before you book.

Your options for getting it signed

The questionnaire asks for your physician’s approval, and the evaluation page’s signature line accepts a certified medical doctor or other legally certified medical provider. In practice, divers have three main routes.

Your own doctor

Your regular doctor knows your history, has your records, and is the natural first call. The catch is that many primary care physicians see this form rarely, and some decline to sign it because diving falls outside their usual practice. That isn’t a verdict on your health, and it’s common enough that I’ve written about what to do if your doctor won’t sign your dive medical. If you go this route, ask early so you have time for a plan B.

A dive medicine physician

Physicians with training in diving and hyperbaric medicine are the specialists. They’re the right choice if your history is complicated or you might need testing in person. DAN runs a referral service that can help you find one. Depending on where you live, the nearest one may be a drive away.

An online evaluation

For straightforward histories, an online evaluation can be the fastest route. A legitimate one reviews your records before a live video visit, and the provider has to be licensed in the state where you are physically located during that visit. Video can handle a lot, but not everything, which I explain in what a video evaluation covers. If an in-person exam or testing is needed, a good service tells you so.

This is the route I offer through DiveSlip: a records review, a live video visit, and the signed form the same day when you can be cleared. It’s $91 flat, I’m licensed in 29 states, and if I refer you to in-person care instead, you get a full refund.

How to plan the timing

The single most useful thing you can do is fill out the questionnaire the day you book your course, not the day before it starts. If you answer no to everything, you’re done in minutes. If you answer yes to something, you’ve just bought yourself time.

From there, a few things take longer than people expect:

• Getting your records. Requesting notes or test results from a doctor’s office can take several days.
• Getting an appointment. Your own doctor may not have an opening this week, and they may decline when you get there.
• Waiting on more information. If the physician needs something you don’t have on hand, you’ll need time to get it.

When the questionnaire calls for a physician, your course can’t go ahead without that approval, so treat it as part of booking rather than an errand for later. PADI’s guidance also says the medical must still be less than one year old when your course is completed. If your training is spread out over several months, check the date.

If you’re heading somewhere warm this winter, so are a lot of other divers. Give yourself a buffer.

A paperwork timeline, from booking to boat

If you like a plan, here’s the one I’d follow.

The day you book. Get your shop’s or boat’s medical requirements in writing and fill out the questionnaire. If every answer is no, sign it and you’re finished.

That same week, if you have a yes. Start the physician step. Request any records related to your yes answers, and book the evaluation.

A few weeks before the trip. Aim to have the signed form in hand, with time left over in case a doctor asks for more information or declines to sign.

A week before. Send a copy to your shop if they want it in advance, and check the date. The approval needs to still be less than a year old when your course finishes.

When you pack. Put a printed copy in your dive bag and a photo of it on your phone.

Day one. Hand the form to your instructor and mention anything that has changed since you filled it out.

After the trip. File a copy with your certification card for next time.

What to bring and how to prepare

A prepared diver turns an evaluation into a short conversation. Before you see anyone, gather:

• All pages of the form your shop sent you, including the questionnaire and the evaluation page.
• Records related to each yes answer, such as recent clinic notes or test results.
• A list of your medications with doses.
• Your regular doctor’s contact details, in case anything needs confirming.
• Your course or trip dates, along with any medical requirements your shop or boat put in writing.

Clear phone photos of documents are usually fine for an online evaluation. For an office visit, ask ahead what they want you to bring.

How long it’s valid and when to renew

Plan on a physician’s approval lasting about a year. PADI’s guidance puts it as needing to be less than one year old at the time a course is completed, and professional-level candidates need clearance within 12 months.

Three situations call for a fresh look:

• Your health has changed. If your answers to the questionnaire would be different now, your old approval no longer describes you. Fill out a new form honestly.
• You’re starting a new course. Many shops ask you to complete a new questionnaire for each course. If your answers haven’t changed and your approval is recent, that approval usually still applies, but ask your shop.
• You’re going pro. Divemaster and instructor training requires clearance within 12 months.

Keep a copy with your certification card. Resorts and liveaboards sometimes ask to see it again.

Do’s and don’ts

Do

• Read your shop’s exact requirements. Some want the standard questionnaire, some want a signed medical from everyone, and some use their own form.
• Fill out the questionnaire as soon as you book. It takes minutes, and it tells you right away whether you need a doctor.
• Answer every question honestly. The form is only useful if it’s accurate, and you sign a statement taking responsibility for your answers.
• Start the doctor step immediately if you have a yes. Records and appointments take longer than the evaluation itself.
• Keep paper and digital copies. Carry them on the trip.
• Check the date before every course. An old approval can lapse partway through a long training plan.
• Tell your instructor about anything that changes. If something new comes up between signing the form and your first dive, say so before you get in the water.

Don’t

• Don’t answer no just to skip the doctor. It defeats the purpose of the form, and you’re the one signing for the answers.
• Don’t wait until the week of the trip. That’s when a declined appointment or a missing record turns into a missed course.
• Don’t take one doctor’s refusal as a no to diving. Many decline the form out of unfamiliarity. A dive medicine physician or an online evaluation is a legitimate second route.
• Don’t use a service that signs without evaluating you. If nobody reviews your history or talks to you, nobody evaluated you.
• Don’t dive while you’re sick. The form says to avoid diving if you’re feeling ill and to stay out of training if you think you may be contagious.
• Don’t sign the form for someone else. Each adult diver answers for their own history. A parent or guardian signs only for a minor.

Diving abroad

Dive centers abroad that train under PADI, SSI or NAUI standards use the same questionnaire, so you can expect the same form whether you’re diving in Mexico or Indonesia. A few habits make it easier:

• Handle the medical before you leave home. If you use an online evaluation, the provider has to be licensed where you are during the visit, which in practice means getting it done before you fly rather than from the resort.
• Carry the form in two formats. A printed copy and a photo on your phone cover you if one goes missing.
• Check what the boat wants. Liveaboards in particular may ask for a signed medical even if you’re already certified.
• Respect the illness rule on the trip. If you pick up something on the flight or at the resort, the form’s advice to avoid diving while ill still applies.

How to spot a legitimate online medical

Online evaluations are a real option, which also means there are services trading on the idea. A legitimate one has a few things in common:

• A named provider whose license you can check. For US physicians, the NPI Registry is free and public.
• A license in the state where you are during the visit.
• An actual evaluation. Someone reviews your history and talks to you. A questionnaire alone isn’t an evaluation.
• The willingness to say no. A service that approves everyone isn’t evaluating anyone. Look for one that tells you plainly which histories it refers for in-person care.
• A document your shop can verify. A signed form with the provider’s name and credentials, ideally with a way for the shop to confirm it.

Be wary of any service that promises approval before anyone has looked at your history. I’ve written more about this in is an online dive medical legitimate?

Final word

The dive medical is one of the few parts of learning to dive that happens entirely on land, and it’s also one of the easiest to get right. Fill out the questionnaire early, answer it honestly, read what your shop actually requires, and give yourself time if you need a doctor. Do that, and the paperwork stays where it belongs, behind you, while you’re on the boat.

If you need your form signed and your history is straightforward, DiveSlip can do it on a short video visit, with the signed form the same day when you can be cleared.