Medical certificate of no-contraindication for the practice of underwater activities
I, Medical Doctor : ...............................................................................
certify that I now the list of underwater activities contraindications having examined
Mr, Mrs, Miss : ....................................................................................
Date of birth : ..........................................
Address : ...................................................................................................................
and attest he (she) does not present, as of this day, any clinically detectable contraindication for the practice of underwater activities.
Date : .................................... at : ....................................................
Signature