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Diving Medical Certificate

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UCPA Diving Medical Certificate for Fitness to Dive

I, undersigned, Dr.

Qualified as:

Medical doctor, general practitioner

Medical doctor approved by FFESSM,

Medical doctor with a French “Médecine du Sport” certificate or equivalent local certificate,

Medical doctor with a specific French degree “Diplôme Universitaire de Médecine de la Plongée” or equivalent degree.

Medical doctor with a Diving or hyperbaric medicine degree,

Certify that:

Patient full name :

Has been examined for fitness to recreational SCUBA diving in accordance with the attached list of preexisting conditions that may affect safety while diving.

And declare that:

• He/she has not reported any previous pathologic problems,

• He/she has not shown any physiological symptoms or functional signs or that could be clinically detected,

that could make him/her be considered as unfit for recreational SCUBA diving.

The patient and the medical doctor certify that they are aware of the list of preexisting conditions that may affect your safety while diving attached.

Date:

Signature of the patient

(Alternatively, the father, mother or guardian when the patient is under 18 year)

Signature of the Medical Doctor and stamp

Note: no UCPA registration will be accepted for a person showing suspicion of asthma. An additional medical visit might be performed upon arrival on the UCPA site as part of UCPA health and safety system.

Source: Free translation of the « UCPA certificats de plongée pour adulte et pour mineur, référence T600-2-3 ».

List of Conditions That Affect or May Affect Safety While Diving (1)

Function Subject unfit for diving Subject temporarily unfit for diving
Cardiology Any active or chronic cardio vascular disease under treatment, Severe ischemic cardiomyopathy, Severe arterial hypertension, Infarcts, Arteriopathy level III and IV, Angina, Paroxystic tachycardia, Treatment with anticoagulants, anti-arrhythmia Beta blockers, Any cardiovascular disease as per evaluation
ENT Unilateral deafness, Bilateral audio deficit > 40 db, Otospongiosis with surgery Infections, Vertigo syndrome, as per evaluation. Recurrent tubular problems, Tympanic holes, Tympanoplasty, as per evaluation after impedancemetry, Major osteomes of the duct,
Pneumology Asthma, Chronic respiratory deficiency, Spontaneous pneumothorax, Active interstitial syndrome, Pulmonary fibrosis, Sacoïdosis level II to III, Pleurisies with liquid Infection pathology, Pleuresis as per evaluation after a respiratory function evaluation, Sacoïdosis level I: as per evaluation after a respiratory function evaluation
Ophthalmology Radial keratomy, Kerathocone, Any retina disease, as per evaluation, Protesis or hollow implant Ocular surgery as per evaluation after one year. Retinal detachment, as per evaluation, Glaucoma, as per evaluation, Visual field reduction, as per evaluation.
Neurology Epilepsy, Cranial trauma with sequels, Frequent loss of consciousness from unknown origin. Endocranial surgery for an active disease.
Psychology Major treatment with anti depressors or anxiolitic neuroleptics
Gynaecology Pregnancy
Dental care Removable prosthesis (will be required to be removed)
Gastrology Night or day gastro-oesophageal burns.
Endocrinology Insulin dependent diabetes Any endocrinal disease, as per evaluation. Spasmophilia as per evaluation

Any ongoing treatment or pharmacologic substance likely to modify the behaviour must be first evaluated.

The authorisation to resume diving after a decompression incident or accident must be granted:

• In France by the “FFESSM approved Regional Medical Doctor”

• Or elsewhere by a medical doctor with diving or hyperbaric medicine degree.

Note 1:

These are general requirements for recreational SCUBA diving considered as a mass activity. A given pathology might be compatible with a diving activity within the frame of a specific structure and a specialised dive organisation, which is not the case for UCPA.

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What the Diving Medical Certificate Is and Why It Matters

A Diving Medical Certificate is a formal medical clearance completed by a licensed healthcare provider that documents a person’s fitness to participate in underwater activities. It typically records relevant medical history, focused physical examination findings, and any restrictions, recommendations, or required follow-up tests. Operators, training agencies, commercial employers, and insurers use the certificate to assess risk, confirm fitness for duty, and ensure compliance with organizational policies. When handled as an electronic record, the document must meet U.S. e-signature rules and health privacy requirements to remain valid and protect patient data.

Why a Clear, Accurate Certificate Protects Divers and Organizations

A correctly completed Diving Medical Certificate supports diver safety, reduces legal exposure, and aligns with employer and insurer requirements while preserving medical confidentiality under HIPAA.

Why a Clear, Accurate Certificate Protects Divers and Organizations

Who Typically Completes and Relies on This Certificate

The Diving Medical Certificate is used by individuals, healthcare providers, and organizations involved in diving operations.

  • Recreational Divers and Students — Individuals seeking SCUBA or freediving training who must prove medical fitness before participation.
  • Licensed Physicians and Occupational Health Clinicians — Providers who perform the exam and certify suitability to dive.
  • Commercial Employers and Dive Operators — Organizations that require clearance to meet safety, insurance, or contractual requirements.

Each party has distinct responsibilities: the clinician documents fitness, the diver provides truthful history, and the operator retains records per policy.

Core Sections Found on a Professional Diving Medical Certificate

A complete certificate is structured for clarity: identity, focused history, exam findings, fitness determination, physician credentials, and explicit restrictions or follow-up items.

Personal Details

Full legal name, date of birth, contact information, and unique ID (employee or student number) for accurate identification.

Medical History

Targeted questions about cardiac, pulmonary, neurological, ENT, and medication history relevant to diving risk assessment.

Physical Exam

Focused exam results including cardiopulmonary status, neurological screen, ear and sinus evaluation, and any test results noted.

Fitness Determination

Clear statement: fit, fit with restrictions, or not fit to dive, with rationale and recommended limitations or re-evaluation timeframe.

Provider Information

Physician name, license number, practice address, contact, signature, and exam date to enable verification.

Restrictions & Follow-up

Specified temporary restrictions, required diagnostic tests (EKG, audiogram, chest imaging), and recommended re-examination interval.

Stepwise Process to Obtain a Signed Diving Medical Certificate

Follow this sequence to complete, sign, and submit a valid Diving Medical Certificate.

  • 01
    Schedule Exam: Arrange an appointment with a provider experienced in diving evaluations.
  • 02
    Complete History: Fill the medical history section fully before the visit to save time.
  • 03
    Undergo Exam: Physician performs focused exam and orders tests if indicated.
  • 04
    Receive Certificate: Obtain the signed certificate in paper or electronic form and distribute as required.

Where to Send or File the Completed Certificate

After signature, route copies to each stakeholder according to organizational policy and legal requirements.

  • Employee / Diver Copy: Provide a signed copy for the individual to retain with personal records.
  • Employer / Operator: Send certified copy to the dive employer for personnel files and operational clearance.
  • Training Agency: If required, supply the training organization to confirm eligibility for courses or certifications.
  • Medical Record: Store original in the clinician’s medical record in compliance with HIPAA retention rules.

Typical Digital Workflow Configuration for eSubmission

Set up a simple workflow to collect, verify, and archive Diving Medical Certificates electronically.

Step Configuration
Upload Document Accept PDF/DOCX upload and validate required fields automatically.
Assign Provider Route the form to the examining clinician for completion and signature.
Authentication Use email or SMS verification; add stronger auth for high-risk roles.
Archive & Distribute Store signed copy with audit trail and send copies to designated recipients.

Technical Considerations for eSigning and Storing Medical Certificates

Choose a platform that documents signer attribution, retains a tamper-evident audit trail, and supports required compliance frameworks.

  • File Formats: PDF and DOCX supported for preservation and portability.
  • Integrations: Connectors for EMR, Google Workspace, and NetSuite enable streamlined routing.
  • Authentication: Options for email, SMS, KBA, or advanced signer verification.

Security and Compliance Essentials for Medical Certificates

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
HIPAA Handling: BAA required for covered entities
Audit Trail: Detailed timestamps and signer attribution
Access Controls: Role-based permissions and SSO
Certifications: SOC 2 Type II and ISO 27001
Accessibility: WCAG 2.0 Level AA support

Typical Validity Periods and Timing Expectations

Expect common timing benchmarks but confirm employer, insurer, or training-agency requirements before relying on a specific validity period.

Initial Clearance:

Result issued immediately after exam if no tests required

Follow-up Testing:

Additional tests (EKG, audiogram) may extend clearance time by days to weeks

Common Validity:

12 months is commonly accepted for recreational diving clearance

Commercial Roles:

Employers may require re-evaluation every 6–12 months depending on duty

Emergency Restrictions:

Temporary deferrals issued until condition is resolved or re-evaluated

Common Preparation Errors to Avoid

  • Incomplete medical history entries that omit relevant cardiac or seizure conditions can trigger additional testing and delay clearance.
  • Mismatched names or missing physician license details prevent acceptance by employers or certifying agencies and require reissue.
  • Using a generic exam report without specific fitness determination or restrictions may not satisfy operational or insurer requirements.
  • Failing to secure proper consent or to follow HIPAA procedures when sharing PHI risks regulatory and contractual violations.

Consequences of an Incorrect or Incomplete Certificate

Denied Participation: Individual barred from dive activities
Insurance Denial: Claims may be refused or contested
Employers' Liability: Increased workplace risk and potential OSHA scrutiny
Regulatory Noncompliance: Possible fines or corrective orders
Patient Privacy Risk: HIPAA violations if PHI mishandled
Medical-Legal Exposure: Provider or organization litigation risk

Typical eSignature Vendor Comparison for Medical Certificate Workflows

Compare basic plan features relevant to processing Diving Medical Certificates; signNow is listed first for parity across columns.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial No No Yes, limited Yes, limited
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

FAQs — Common Questions About Diving Medical Certificates

Answers address execution, e-signing, privacy, signatures, validity, and next steps commonly asked by clinicians, divers, and employers.


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