Registry

REGISTRY
of  
Adaptive Scuba Instructors, Support Divers and Adaptive Divers

This registry was created for the purpose of identifying certified adaptive scuba instructors, adaptive dive buddies and other support divers who have an interest in providing  services or volunteering  to support adaptive scuba training, discover SCUBA events, dive trips, academic programming, scuba therapy, and research.

This registry will also serve as an “instructor locator” for individuals with a disability to help them find certified adaptive scuba instructors in their locality.

In addition, we have also created a registry for adaptive divers  and any individual with a disability who is interested in participating in an adaptive scuba  event or program, so that TSI and other adaptive SCUBA organizations, can keep them informed  of such activities.

All registrants will receive our quarterly newsletter covering the latest news and happenings in the adaptive scuba world.

This is a completely free service provided by TSI.

To join please click  the registry that applies to you  and complete the PDF fillable registration form.

Adaptive Scuba Diver Registry

To Be Completed by New Participants, Adaptive Divers, Parents or Guardians:

Participant-Adaptive Diver Information:  

Military Service:

Emergency Contact:

Medical Clearance Physician Information (if required)

Medical History:

Describe your general health and any medical, emotional or psychological condition which impacts, to any extent, your activities of daily living and/or which you believe may affect your ability to SCUBA dive:

Describe specifically any such physical impairment involving your arms?

Describe specifically any such physical impairment involving your legs?

Do you currently have any open skin wounds?

Have you ever had a seizure?

Have you ever suffered from autonomic dysreflexia?

Hearing: (Circle all that apply)

Vision: (Circle all that apply)

Do you use any medical devices related to your condition: (Circle all that apply)

Other devices and/or supplies:

Current Medications:

Surgical Implants/ Infusion Devices:

SWIMMING SKILLS & EXPERIENCE:

Past SCUBA Experience & Certifications:

Waiver

VERIFICATION:

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Adaptive Scuba Buddy Registry

Adaptive Scuba Certifications:

Please list all of your adaptive scuba certifications, starting with the highest-level first:

a. Name or Level of certification:

b. Name or Level of certification:

Other Scuba Certifications:

Please list any other scuba certifications, starting with the highest-level first:

a. Name or Level of certification:

b. Name or Level of certification:

c. Name or Level of certification:

Generally describe how often you scuba dive

Generally describe the type of adaptive scuba programs and number of times you have participated

Please describe any other special experience or qualifications with adaptive scuba.

Please check off the types of adaptive scuba programs you would like to get involved with:

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Adaptive Scuba Instructor Registry

Adaptive Scuba Certifications:

Please list all of your adaptive scuba certifications, starting with the highest-level first:

a. Name or Level of certification:

b. Name or Level of certification:

Other Scuba Certifications:

Please list any other scuba certifications, starting with the highest-level first:

a. Name or Level of certification:

b. Name or Level of certification:

c. Name or Level of certification:

Generally describe how often you scuba dive

Generally describe the type of adaptive scuba programs and number of times you have participated

Please describe any other special experience or qualifications with adaptive scuba.

Please check off the types of adaptive scuba programs you would like to get involved with:

Thank you! Your submission has been received!
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