DAN Medical Clearance Guide for Hawaiʻi Divers
- Michael Burns
- 2 days ago
- 7 min read
Scuba diving in Hawaiʻi is an unforgettable experience—but before you enter the water, your dive operator or instructor may ask you to complete a Diver Medical Participant Questionnaire. For many divers, the form takes only a few minutes and no medical appointment is needed. For others, certain answers mean a medical evaluation and written clearance must be completed before diving.
The purpose of this process is not to keep people out of the water. It is to identify health conditions that may behave differently under pressure, during immersion or while breathing compressed gas. The Divers Alert Network (DAN) emphasizes that honest medical screening helps divers and operators prevent emergencies and enables a qualified medical professional to assess an individual diver’s risk.
This guide explains how recreational diving medical screening works, which answers may require clearance and what Hawaiʻi divers can do if they need help shortly before a scheduled dive.
What is the Diver Medical Participant Questionnaire?
The Diver Medical Participant Questionnaire is part of the Recreational Diving Medical Screening System. It was developed by an international group of diving-medicine experts with input from DAN and the Undersea & Hyperbaric Medical Society (UHMS), and it is endorsed by UHMS and the World Recreational Scuba Training Council. It is widely used by training organizations and dive operators, including PADI professionals.
The complete screening system includes:
The participant questionnaire completed by the diver
The physician’s evaluation form used when professional medical review is required
Medical guidance that helps the evaluating clinician understand how specific conditions may affect diving
The form is a screening tool—not a diagnosis and not an automatic rejection from diving. According to DAN’s health-status guidance, many healthy divers and people with well-controlled conditions pass the initial screen quickly, while other answers indicate that an individualized medical evaluation is appropriate.
Does every diver in Hawaiʻi need a doctor’s clearance?
No—not every recreational diver automatically needs a medical professional to sign a clearance form. Your exact requirements depend on the activity, training agency and dive operator.
All PADI student divers complete a medical questionnaire before participating. If their
answers do not trigger an evaluation, they can generally sign the participant statement and continue. If the form indicates medical review is required, a qualified medical professional must assess the diver’s fitness and provide approval before in-water training. PADI also notes that local laws or regulations may impose additional requirements in some destinations.
Certified divers joining recreational charters should not assume that an old certification card replaces current medical screening. A Hawaiʻi dive operator may require every guest—including experienced certified divers—to complete its current questionnaire and follow its safety policy. Always review the operator’s requirements before the cancellation deadline and well before departure.
Scientific, occupational, public-safety and commercial diving programs may require more extensive examinations and testing. Those standards are different from the recreational screening process discussed here.
Which answers require a medical evaluation?
Read the instructions carefully before deciding what your answer means. A “Yes” on the first page does not always mean immediate clearance is required; some answers direct you to a follow-up section on page 2.
Under the current Diver Medical Participant Questionnaire, a medical evaluation is required when you answer:
Yes to question 3: difficulty performing moderate exercise, or an inability to participate in normal physical activity for health or fitness reasons during the previous 12 months
Yes to question 5: surgery within the previous 12 months or ongoing problems related to earlier surgery
Yes to question 10: current prescription medication use, except the specific exclusions stated on the form
Yes to any starred follow-up question on page 2
Questions 1, 2, 4, 6, 7, 8 and 9 initially direct the diver to the matching follow-up box on page 2. A “Yes” to one of the starred items in that box requires medical evaluation. For example, being over age 45 by itself sends you to Box B; clearance is triggered if you are also answering “Yes” to one of the listed cardiovascular risk factors.
The form screens for issues involving the heart and circulation, lungs and breathing, ears and sinuses, neurological health, mental and behavioral health, diabetes, gastrointestinal conditions, physical capacity, recent surgery, certain medications and other factors that could affect safety underwater. These conditions do not all mean a person cannot dive. They mean the risk deserves individual assessment by a medical professional.
The form also states that anyone who is pregnant or attempting to become pregnant should not dive. If you are ill, have symptoms not addressed by the questionnaire or are concerned about your fitness, postpone the dive and consult a healthcare professional even if the form does not formally trigger clearance.
Why do medical conditions matter more underwater?
Diving places demands on the body that are different from ordinary land-based exercise. Immersion shifts blood toward the chest, pressure changes affect air-filled spaces, breathing gas becomes denser with depth, and a diver must sometimes swim against current, climb a ladder in equipment or assist a buddy.
The UHMS medical guidance for clinicians focuses on conditions that could increase the risk of decompression sickness, lung overexpansion and arterial gas embolism, loss of consciousness, impaired judgment or an inability to meet the physical demands of a dive. A condition that is stable during everyday life may still require a dive-specific assessment.
That is also why your instructor, divemaster or boat crew cannot diagnose a condition, interpret your medication or waive a required medical evaluation. Dive professionals enforce the screening requirements; licensed medical professionals make medical fitness decisions.
What happens during a dive medical evaluation?
The medical professional reviews your questionnaire, health history, current medications and the reason the form triggered an evaluation. Depending on the condition, the provider may ask about symptoms, exercise tolerance, prior procedures, recovery, recent testing or specialist care. Some people can be evaluated promptly; others may need records, an examination or additional testing before a safe decision can be made.
If the provider determines that you are medically suitable, the clearance should clearly state that you are fit to scuba dive or freedive. PADI’s medical-screening FAQ explains that medical approvals should not rely on conditional depth limits such as “cleared only to 30 feet”; the standard evaluation is a fitness decision rather than a substitute for training, certification or dive planning.
Clearance is never guaranteed. A medical professional may defer a decision, request additional records or determine that diving is not advisable at that time.
What should you bring or submit?
To help avoid delays, prepare the following:
All three pages of the current Diver Medical Participant Questionnaire
Pages 1 and 2 completed honestly, signed and dated where required
A current medication list, including doses
Relevant medical or surgical history and the dates of recent procedures
Recent test results or specialist notes if they relate to the flagged condition
The name and contact information of your dive operator or instructor
Your dive date, planned activity and any deadline for submitting the clearance
Ask your dive operator whether it accepts electronic forms and whether it has a specific documentation policy. Ocean Therapy Charters requires participants who need clearance to submit all three completed pages before departure.
How long is scuba medical clearance valid?
Do not assume that a previous clearance will automatically be accepted for a new trip. UHMS describes the questionnaire and physician evaluation as a snapshot of the diver’s health status and notes that the form itself has no inherent expiration date. DAN explains that clearance is commonly treated as valid for about one year, while training agencies, operators and local regulations may set their own time limits.
Regardless of the date on an earlier form, seek a new evaluation after a meaningful health change—such as a new diagnosis, new prescription medication, surgery, hospitalization, significant injury or new cardiopulmonary or neurological symptoms. Confirm acceptance with the operator before you travel.
The smartest approach: complete the form early
DAN recommends reviewing the medical questionnaire well before a dive trip. Waiting until check-in can leave too little time to obtain records or schedule an evaluation. It can also result in a missed dive when clearance is required but has not been submitted.
For the smoothest experience:
Download the current form when you book.
Read every question and follow each page-2 instruction.
Answer honestly—do not omit a condition to protect a reservation.
Send the completed form to the dive operator early if requested.
If medical review is triggered, schedule it before the operator’s deadline.
Bring a copy of the signed clearance with you.
Your primary care clinician may be able to complete the evaluation, especially if they know your medical history and review the UHMS guidance. If they are unfamiliar with diving medicine, DAN maintains a physician referral network and offers a non-emergency medical information line at +1 (919) 684-2948 during published business hours.
Need a last-minute scuba medical clearance in Hawaiʻi?
Sometimes a diver learns shortly before departure that clearance is required. In other cases, a primary care office does not offer dive-fitness evaluations, cannot schedule an appointment in time or is not comfortable assessing the effects of pressure and compressed-gas diving.
IV Ocean Therapy’s Scuba Diving Medical Clearance service offers HIPAA-compliant telehealth evaluations through a licensed Hawaiʻi medical provider familiar with the physical and medical demands of scuba diving. Divers complete pages 1 and 2 of the questionnaire, submit all three pages and participate in an individual medical review. When medically appropriate, the provider completes the evaluation form and can coordinate the documentation with the dive shop.
Current review options include:
Standard Review: 24–72 hours — $80
Priority Review: within 4 hours — $120
Express Review: within 1 hour — $150
Turnaround times are service targets, not a guarantee that medical clearance will be issued. Eligibility depends on the individual evaluation, and additional information or in-person care may sometimes be necessary.
To schedule, visit IV Ocean Therapy or call 808-431-7333. Complete the process as early as possible so medical safety—not the clock—guides the decision.
This article provides general educational information for recreational divers and is not medical advice. It does not replace an individual evaluation, emergency care, training-agency standards, operator policies or applicable law. If you have urgent symptoms or a diving emergency, call 911 and contact DAN’s 24-hour emergency hotline.
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