If you answered YES to any medical questions, you wii need your doctor's signature to dive. This document is the complete medical form plus
4 pages of guidelines for your doctor.
Forms for SCUBA Diver Training and related activities 2011
Download and fill out your required forms in black pen.
Parent must also sign if you are under 18 years of age.
Mail to: Luke Clyburn 9000 Gale Road White Lake, MI 48386
These must arrive before the training begins!
All SCUBA students fill out the Medical Statement. Answer questions YES or NO. (do not use an "X") If you answer "YES" to any question, you must have your doctor sign page 2 and check the appropriate box under Physician's Impression
