Membership Form

To be a member of Scavenger Dive Boat club, please complete the following form;

Medical Questions (please read the questions and choose one or the other options at the end);

  • Have you ever suffered at any time from diseases of the heart and circulation including high blood pressure (or taking tablets for high blood pressure), angina, chest pains or palpitations?
  • Have you ever had chest or heart surgery?
  • Have you ever had significant bleeding or blood disorders?
  • Have you ever suffered from asthma, chronic obstructive airways disease or ever used an inhaler?
  • Have you ever had collapsed lung, pneumothorax or other lung injury?
  • Have you ever had any other problem affecting the lungs, suspected or known COVID-19 or tested positive for COVID-19?
  • Have you ever suffered from blackouts, fainting or recurrent dizziness?
  • Have you ever had abdominal surgery, Ileostomy, colostomy or repair of a hiatus hernia?
  • Have you ever had epilepsy or fits?
  • Have you ever had recurrent migraines?
  • Have you ever had any other disease of the brain or nervous system (including strokes or multiple sclerosis)?
  • Have you had back or spinal surgery or any serious back problems?
  • Have you ever had psychological illness of any kind, fear of small spaces, suicidal thoughts or panic attacks?
  • Do you have diabetes?
  • Have you ever had cancer, malignant disease or a tumour?
  • Have you ever had a requirement for any prescribed medication (except the contraceptive pill)?
  • Have you ever had, or been treated for, decompression illness, immersion induced pulmonary oedema or other diving related problem??
  • Have you had regular ear problems in the past ten years?
  • Have you had a head injury with loss of consciousness in the past 5 years?
  • Have you had any problem with alcohol or drug abuse in the last five years?
  • Have you ever been refused a diving medical certificate or life insurance or been offered special terms?
  • Are you currently receiving medical care or have you consulted a doctor in the last year other than for mild self limiting illnesses that have completely resolved? (Please discuss any symptoms of the upper or lower respiratory tract including Covid19 with a UKDMC Medical Referee).
  • Are you concerned about any other medical issue that has not been covered by the questions on this page?

Declarations;

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