Diving Inquiry Form

I. Personal Information

First Name

Last Name

Date of Birth

Email

Phone Number

Mailing Address

City

State/Province

Postal/Zip Code

Emergency Contact

First Name

Last Name

Phone Number

Relationship

II. Diving Experience & Certification

Are you a certified diver?

If yes, what certification level do you hold?

Open Water Diver

Advanced Open Water Diver

Rescue Diver

Divemaster

Instructor

Other:

Certifying Agency:

PADI

SSI

NAUI

BSAC

Date of Certification:

Number of logged dives:

Date of last dive:

Have you dived in the past 12 months?

If no, how long has it been since your last dive?

What type of diving experience do you have? (Check all that apply)

Recreational Diving

Technical Diving

Wreck Diving

Cave Diving

Night Diving

Deep Diving

Drift Diving

Underwater Photography/Videography

Other (Please specify):

Are you interested in any specific diving courses or certifications?

If yes, please specify:

III. Dive Preferences & Interests

What type of diving environment are you most interested in? (Check all that apply)

Warm water/Tropical reefs

Cold water

Wrecks

Caves/Caverns

Marine life viewing

Photography/Videography

Other (Please specify):

Are you interested in guided dives or independent diving?

Guided

Independent (If certified)

What is your preferred dive depth range?

Are you interested in shore dives or boat dives?

Shore

Boat

Both

Do you have any specific dive sites you would like to visit?

Do you have your own diving equipment?

If no, do you require rental equipment?

If yes, please specify what equipment you need:

BCD

Regulator

Wetsuit

Fins

Mask

Dive computer

Other:

Do you have any experience with using enriched air nitrox?

Are you interested in diving with nitrox?

IV. Health & Fitness

Please answer the following questions honestly and to the best of your knowledge. Your safety is our priority.

 

Do you have any current or past medical conditions that may affect your ability to dive safely? (e.g., heart conditions, lung conditions, ear problems, sinus problems, epilepsy, diabetes, high blood pressure, asthma, allergies, recent surgeries, etc.)

If yes, please provide details:

Are you currently taking any medications?

If yes, please list all medications:

Do you smoke?

Do you consume alcohol regularly?

Are you pregnant or think you might be pregnant?

Do you have any physical limitations or disabilities that we should be aware of?

If yes, please provide details:

Have you ever experienced any problems while diving before?

If yes, please provide details:

V. Liability Release and Agreement

I understand and acknowledge the risks associated with scuba diving and related activities.

I certify that the information I have provided on this form is true and accurate to the best of my knowledge.

I agree to release [Dive Center Name] and its staff from any liability for injuries or damages that may occur during my participation in diving activities.

VI. Additional Information/Requests

Please let us know if you have any other questions, requests, or special needs.

 

Thank you for completing this form. We look forward to diving with you!

 

Inquiry Form Insights

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This diving inquiry form is designed to gather comprehensive information about potential divers to ensure their safety and tailor their diving experience. It's a crucial first step for any reputable dive operation. Here's a breakdown of its key aspects:


1. Personal Information: This section collects basic contact details for the diver and an emergency contact. This is essential for communication and in case of emergencies.


2. Diving Experience & Certification: This is arguably the most important section. It aims to understand the diver's skill level, experience, and recent activity. Questions about certification, number of dives, and date of last dive help the dive operator assess the diver's proficiency and determine if refresher courses or additional training might be necessary. Asking about specific diving experiences (wreck, cave, night, etc.) allows the operator to match divers with suitable dive sites and activities. It also identifies potential areas where the diver might need guidance or supervision.


3. Dive Preferences & Interests: This section focuses on the diver's desires and expectations. Understanding what kind of diving environment they prefer (warm water, cold water, wrecks, etc.), whether they prefer guided or independent diving, and their preferred depth range helps the operator plan dives that the diver will enjoy. Information about equipment needs allows the dive center to prepare rentals in advance. Asking about nitrox experience and interest helps the operator cater to divers who prefer or are interested in using enriched air.


4. Health & Fitness: This section is critical for safety. Scuba diving can be physically demanding, and certain medical conditions can pose serious risks. The questions about medical history, medications, smoking, alcohol consumption, pregnancy, and physical limitations are designed to identify potential health issues that might make diving unsafe. It's important to be upfront and honest in this section. Dive operators often require a medical statement from a doctor if a diver answers "yes" to any of the medical questions. This is not meant to be intrusive but to prioritize the diver's well-being. Questions about previous diving problems help the operator understand if the diver has had any negative experiences and take appropriate precautions.


5. Liability Release and Agreement: This section is standard practice for most adventure activities. It acknowledges the inherent risks associated with diving and releases the dive operator from liability for accidents or injuries that may occur, provided they are not due to negligence on the operator's part. This section is usually signed upon arrival at the dive center.


6. Additional Information/Requests: This section provides an opportunity for the diver to communicate any specific needs, questions, or requests that haven't been covered in the form. This could include dietary restrictions, special equipment requirements, or any other relevant information.


Overall Purpose: The primary purpose of this inquiry form is to gather enough information to ensure the diver's safety and to create a positive and enjoyable diving experience. It allows the dive operator to assess the diver's skills, experience, and health status, and to tailor the diving activities to their individual needs and preferences. It's a crucial tool for responsible dive operations.


Mandatory Questions Recommendation

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While the necessity of specific questions can depend on the dive operation's policies and local regulations, the following questions on this client intake form are generally considered mandatory for safety and operational reasons:

Section 1: Personal Information

  • Full Name: Essential for identification and communication.
  • Date of Birth: Important for age verification and potentially linking to specific regulations or insurance requirements.
  • Email Address: Crucial for sending confirmations, pre-dive information, and potentially emergency updates.
  • Phone Number: Necessary for immediate contact, especially in case of last-minute changes or emergencies.
  • Emergency Contact Name: Absolutely vital in case of an accident or medical situation.
  • Emergency Contact Phone: The means to reach the emergency contact.
  • Emergency Contact Relationship: Helps understand the contact's connection to the diver.

Section 2: Diving Experience & Certification

  • Are you a certified diver? This is the fundamental question to determine if the individual is qualified to dive.
  • If yes, what certification level do you hold? Determines the diver's training and limitations.
  • Certifying Agency: Helps verify the legitimacy of the certification.
  • Date of Certification: Provides context for the diver's experience level.
  • Number of logged dives: Gives a quantifiable measure of the diver's experience.
  • Date of last dive: Crucial for assessing recency of experience and potential need for a refresher.

Section 4: Health & Fitness

  • Do you have any current or past medical conditions that may affect your ability to dive safely? This is paramount for the diver's safety and the dive operator's liability. A "yes" answer necessitates further inquiry.
  • If yes, please provide details: Allows the operator to understand the specific condition and potentially require a medical clearance.
  • Are you currently taking any medications? Certain medications can have implications for diving safety.
  • If yes, please list all medications: Provides necessary information for safety assessment.
  • Are you pregnant or think you might be pregnant? Pregnancy is generally considered a contraindication for diving.

Why these are mandatory:

  • Safety: These questions directly address the diver's ability to safely participate in diving activities. Medical conditions, certification level, and recent diving experience are critical factors in risk assessment.
  • Legal and Insurance Requirements: Dive operators often have legal obligations and insurance policies that require them to collect this information.
  • Operational Efficiency: Basic contact information is essential for managing bookings and communicating with clients.
  • Duty of Care: Responsible dive operators have a duty of care to their clients, and collecting this information is a fundamental aspect of fulfilling that duty.

Important Considerations:

  • While other questions are highly recommended for tailoring the experience, the ones listed above are generally non-negotiable for safety and operational integrity.
  • Depending on local regulations and the specific types of diving offered, additional questions might also be considered mandatory.
  • A responsible dive operator will likely require further documentation (e.g., certification card, medical statement) based on the answers provided in these mandatory sections.

In summary, the mandatory questions focus on identifying the diver, assessing their qualifications and recent experience, and understanding their health status to ensure a safe diving experience for everyone involved.


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