This questionnaire will only be used for purpose of assessing fitness to dive/work offshore. The questionnaire meets the US HIPAA (Health Insurance Portability & Accountability Act) requirements for medical information. A password protected FILLED copy will be sent to you after submission. Please print a copy to bring to clinic.
SECTION B
SECTION C
SECTION D
Medical Fitness Recommendations
Dr Gregory Chan Chung Tsing, PPA(G), PP
MBBS, MMED Occup Med, GDip Geriatric Med, GDip FP Derm, Cert DHM (Adelaide, Toronto), DWD (All hazards)
Senior Specialist Physician, Occupational Medicine
MCR: M06367C