Comprehensive Fitness-to-dive Medical Guide
Peter Letts Mar 13, 2022
Fitness to dive • Updated August 2026
Do You Need a Dive Medical in Australia?
Find out when a medical questionnaire is enough, when a doctor must approve you, and what to organise before your PADI course.
Start here
Do you need a dive medical for an Abyss course?
Every student completes the current Diver Medical Participant Questionnaire before a PADI scuba or freediving course. A doctor’s evaluation is required only when the completed form directs you to obtain one, unless a separate law, course standard or Abyss instruction applies.
- If you answer No to all 10 questions, the 2026 form says a medical evaluation is not required.
- If you answer Yes to question 1, 2, 4, 6, 7, 8 or 9, follow the arrow to the relevant box on page 2. The follow-up answers decide whether an evaluation is required.
- If you answer Yes to question 3, 5 or 10, or to any item on page 2, take all three pages to a doctor. Medical evaluation is required.
- A Yes answer does not automatically disqualify you. It means the condition needs the review specified by the form.
Check that the form you use is marked Version date: 2026-01-01. Complete it early. If clearance is required, it must be provided by the deadline in your course information; you cannot join the in-water training without required clearance.
Requirements without the myths
What are the current Australian dive medical requirements?
There is no single medical rule that applies to every recreational diver in every Australian state. Your obligations depend on where you dive, whether you are training or already certified, the training agency or operator, and whether the dive is recreational or work.
For an Abyss recreational course in Sydney, follow the current PADI questionnaire and the instructions supplied with your course. Queensland has additional legislation for entry-level and non-certified diving. Occupational diving in NSW uses a separate workplace medical system.
| Situation | What applies | What to do |
|---|---|---|
| PADI recreational course with Abyss in Sydney | Current PADI medical screening plus Abyss course requirements. | Complete the questionnaire. Obtain a doctor’s approval only when the form or Abyss instructs you to. |
| Certified recreational diver | Personal fitness-to-dive decision, operator requirements and any applicable local rules. | Do not rely on an old form if your health, medication or fitness has changed. Seek medical advice when concerned. |
| Entry-level or non-certified dive in Queensland | Safety in Recreational Water Activities Regulation 2024, sections 10–11. | Give the operator the regulator-approved medical declaration. A medical certificate is required when that declaration directs an evaluation; WorkSafe Queensland says it must be issued within 90 days before the course. |
| Occupational diving work in NSW | NSW workplace law and AS/NZS 2299.1:2015 requirements. | Workers need a current certificate of medical fitness, valid for 12 months, following assessment by a doctor trained in underwater medicine. |
Important correction: AS 4005.1 is withdrawn
AS 4005.1:2000, the former Australian entry-level recreational scuba standard, is listed by Standards Australia as withdrawn. It should not be described as the current Australian law or as proof that every recreational student must obtain an annual medical certificate. Australian standards are not automatically laws unless legislation incorporates them. Current recreational training standards include the AS ISO 24801 series, while medical screening is governed by the applicable course, operator and state requirements.
See the withdrawn AS 4005.1 listing | See current AS ISO 24801.2:2021 | How standards interact with law
SPUMS best-practice advice
The South Pacific Underwater Medicine Society recommends assessment before first commencing compressed-gas diving and after a significant illness or change in health. From age 45, its current guidance recommends cardiovascular-focused assessment with reassessment intervals of no more than five years. That is expert medical guidance; it is not the same thing as a blanket legal requirement or a PADI questionnaire trigger for every Australian recreational diver.
Four clear steps
How to complete the dive medical questionnaire
The questionnaire is a screening tool, not an exam to pass. Its purpose is to identify health matters that may need a doctor’s assessment before pressure, immersion, exertion and an underwater emergency make them harder to manage.
Use the complete current form
Download all three pages of the form dated 2026-01-01. Page 1 is only the start; several Yes answers send you to follow-up boxes on page 2.
Answer honestly
Include past and current conditions, surgery, medication and changes in fitness. If you are unsure how to answer, do not guess—contact Abyss or your doctor.
See a doctor if directed
Take all three pages. The doctor reviews your suitability for recreational scuba or freediving and marks Approved or Not Approved on page 3.
Return it before training
Send the completed paperwork as instructed and keep Abyss informed if anything changes. Do not leave required clearance until the morning of the course.
What the doctor should complete
The current form asks the examiner to select either Approved or Not Approved. PADI states that added limits or conditions can invalidate the approval for some agencies or organisations, so ask the doctor to complete the form itself rather than supplying a general note with restrictions.
If the doctor wants more detail, the form directs medical practitioners to the UHMS Diving Medical Guidance.
Health and fitness
Which conditions can affect fitness to scuba dive?
No short web list can decide who is fit to dive. The question is whether a condition, its treatment or its medication could impair breathing, circulation, consciousness, judgement, movement, pressure equalisation or the ability to manage exertion and an emergency underwater.
Heart, circulation and exercise tolerance
Chest pain, heart disease, abnormal rhythms, heart surgery, implanted devices, stroke, high blood pressure and reduced exercise capacity may require assessment. Immersion increases the work placed on the heart, and an underwater loss of consciousness can be fatal.
Lungs and breathing
Asthma, wheeze, chronic lung disease, recurrent bronchitis, a previous collapsed lung, chest surgery or continuing respiratory symptoms can create risks including air trapping and pulmonary barotrauma. Individual assessment matters; a diagnosis is not something an instructor can clear.
Ears, sinuses, eyes and teeth
Ear disease or surgery, hearing or balance problems, recurrent sinusitis and recent eye, sinus or dental procedures may affect safe pressure equalisation. Pain, vertigo or inability to equalise are reasons to stop, not push deeper.
Neurological conditions
Seizures, blackouts, fainting, significant head injury, stroke, recurring migraines and conditions that can cause unpredictable neurological impairment need careful review because symptoms can be disabling and may resemble decompression illness.
Diabetes, digestive illness and surgery
Diabetes, dehydration, active gastrointestinal illness, reflux, ulcers, ostomy or bariatric surgery, back problems and hernia appear in the current screening system. Some people can dive with well-managed conditions and an appropriate plan; others need to wait or avoid diving.
Mental health, panic and substance use
Mental health conditions are not an automatic exclusion. The assessment considers stability, treatment, medication effects, judgement and the likelihood of panic or sudden impairment. Current alcohol or drug impairment is incompatible with safe diving.
Who should not scuba dive today?
Do not dive when you are acutely unwell, feverish, contagious, vomiting, experiencing diarrhoea, dehydrated, short of breath, unable to equalise, affected by alcohol or drugs, or impaired by a medication. Do not dive with new chest pain, fainting, unexplained neurological symptoms or a major health change until assessed. The current questionnaire also says not to dive while pregnant or attempting to become pregnant.
Ears and equalisation: do not use ordinary earplugs
The previous version of this article recommended earplugs to prevent ear problems. That advice is unsafe. Solid earplugs can trap an air space in the ear canal and cause external-ear barotrauma as pressure changes.
Equalise early and gently, before discomfort develops. If an ear will not equalise, stop your descent and ascend slightly; never force it. Do not dive with congestion. Seek medical care for persistent pain, hearing loss, vertigo, bleeding or discharge, and do not return until a doctor says the injury has healed and equalisation is normal.
Prescription medication and diving
Do not stop or change medication to avoid a Yes answer. A doctor needs to consider the underlying condition, whether it is stable, the drug’s side effects, interactions and whether those effects could be worsened or confused by diving.
Question 10 of the 2026 form covers current prescription medication but says the answer need not include birth control, menopausal hormone replacement or antimalarial medication unless it is mefloquine (Lariam). That exception is part of the screening logic; it is not a guarantee that every person or medication is suitable for diving. Ask your doctor whenever you have a concern.
There is no ideal diver body type
Fitness to dive is about function, not being small or having low body fat. A diver needs enough aerobic capacity, strength, mobility and water comfort to manage equipment, surface swims, current, exits and assistance to a buddy.
The medical questionnaire uses walking 1.6 km in 14 minutes or swimming 200 m without resting as examples of moderate exercise. That is a screening prompt, not a complete fitness test. The PADI Open Water course separately includes a 200 m swim and a 10-minute float or tread-water check.
Getting assessed
How to find and prepare for a diving medical doctor
Can any GP sign a recreational diver medical?
The PADI form provides a space for a certified medical doctor or other legally certified medical provider. A doctor may decide that specialist or diving-medicine advice is needed. For complex heart, lung, neurological, ENT or medication questions, a doctor trained in diving medicine is the stronger choice because ordinary activities do not reproduce the effects of pressure, immersion and breathing compressed gas.
Use the SPUMS Diving Doctors List to search for a practitioner. Occupational diving has stricter requirements and should be booked specifically as an occupational diving medical.
Take with you
- All three pages of the current questionnaire
- A list of every prescription and non-prescription medicine, dose and reason
- Relevant medical, surgical and diving history
- Specialist letters or recent test results if relevant
- Your course date and the deadline for returning clearance
The assessment may include
- Discussion of your history, symptoms and planned diving
- Heart, lung, ear, nose, throat and neurological examination
- Review of exercise capacity and medication effects
- Targeted tests or specialist referral when clinically indicated
- A decision recorded on the Medical Examiner’s Evaluation Form
Honest answers protect you and your dive team
An instructor cannot diagnose a condition, approve a medication or override a medical decision. Complete the screening accurately and tell Abyss if your health changes after you sign it. New illness, injury, surgery, pregnancy, medication or reduced exercise tolerance can make an earlier answer outdated.
If you are uncertain, pause the paperwork and ask. A short delay for the right advice is safer and usually simpler than discovering a missing clearance on course day.
A separate system
Recreational and occupational dive medicals are not interchangeable
Commercial, scientific and other diving work is governed by workplace safety law. SafeWork NSW says workers must hold a current medical fitness certificate valid for 12 months and that assessment must follow AS/NZS 2299.1:2015 and be performed by a doctor trained in underwater medicine.
This article’s PADI questionnaire pathway is for recreational training and activity. If you will dive as part of paid work, scientific research or another occupational role, confirm the exact workplace category, medical and competency requirements with the employer or training provider.
After a dive
Treat unusual post-dive symptoms seriously
Decompression illness is not simply the result of a “faulty computer” or one fast ascent, and it can occur after an apparently routine dive. Unusual fatigue, joint or muscle pain, rash, numbness, tingling, weakness, vertigo, difficulty walking, confusion, breathing difficulty or collapse after diving need prompt medical assessment.
Stop diving. For serious symptoms, call Triple Zero (000). Provide emergency oxygen if trained and equipment is available, then seek specialist diving-medical advice. Do not wait for symptoms to become severe, do not return underwater for in-water recompression, and do not assume that improvement on oxygen means the problem has resolved.
Common questions
Dive medical FAQs
Do I need a medical to learn scuba diving in Sydney?
Every Abyss PADI student completes the Diver Medical Participant Questionnaire. A doctor’s evaluation is required if the completed form directs one, or if another applicable course or legal requirement applies. Complete the form before your in-water training.
Does answering Yes mean I cannot dive?
No. Some Yes answers lead to follow-up questions; others require a doctor’s evaluation. The purpose is to identify and assess risk. The doctor, not the instructor or the website, makes the individual medical decision.
How long is a recreational dive medical valid?
Use the validity and deadline specified by the form, course, operator and doctor. Never assume an old clearance remains sufficient after a change in health, fitness, surgery, pregnancy or medication. Occupational diving in NSW uses a separate certificate valid for 12 months.
What happens during a dive medical?
The doctor reviews your history, symptoms, medication, planned diving and relevant physical health. Examination commonly considers the heart, lungs, ears, nose, throat, neurological function and exercise capacity. Tests and specialist referral depend on the individual findings; not every person needs the same tests.
Who should not scuba dive?
A web page cannot provide a universal exclusion list. People who are acutely ill, impaired, unable to equalise or directed by the medical form to seek evaluation should not dive until the issue is resolved or properly assessed. Conditions that can cause sudden unconsciousness, breathing difficulty or loss of function require particular caution and medical review.
Can I scuba dive with asthma, diabetes or a heart condition?
These diagnoses are not all automatic lifetime bans, but each can introduce serious risks and appears in the medical screening system. Suitability depends on the exact condition, control, complications, treatment, exercise capacity and planned diving. Complete the form and obtain an individual medical assessment when directed.
What body type is best for scuba diving?
There is no preferred body shape or size. What matters is adequate cardiovascular fitness, strength, mobility, water comfort and the ability to manage the equipment, conditions and a foreseeable emergency. Any relevant health risks should be assessed on their merits.
Do children and teenagers need extra medical review?
The PADI questionnaire requires a parent or guardian signature for a minor. Separately, SPUMS recommends that all prospective child and adolescent divers receive a medical health-risk assessment before compressed-gas training and after any significant health event. Parents should discuss the intended course and the young person’s maturity, health and development with Abyss and an appropriately experienced doctor.
Your next step
Complete the medical step before choosing the water
Starting for the first time? Complete the questionnaire and compare upcoming PADI Open Water dates. Already certified? Use the training hub to find the course that matches your experience. If anything in your health history is unclear, contact the Abyss team before booking.
Questions? Call (02) 9583 9662 or email dive@abyss.com.au.
Authoritative sources checked
- PADI / Diver Medical Screen Committee: Diver Medical Participant Questionnaire, version 2026-01-01
- PADI: forms and medical-screening instructions
- Standards Australia: AS 4005.1:2000 listed as withdrawn
- Queensland: Safety in Recreational Water Activities Regulation 2024
- WorkSafe Queensland: current recreational diving medical-fitness guidance
- SafeWork NSW: diving-work medical requirements
- Safe Work Australia: Australian standards and the law
- South Pacific Underwater Medicine Society: Recreational Diving Medical, sixth edition, September 2025
- Undersea and Hyperbaric Medical Society: Diving Medical Guidance to the Physician
- Divers Alert Network: middle-ear barotrauma and earplug warning
Published 13 March 2022 • Substantially reviewed and updated 6 August 2026.
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