C-19  Access Control Declaration for the SEA LEOPARD


ALL passengers are to complete the following questionnaire prior to boarding the vessel, SEA LEOPARD

1)  I agree to adhere to 

 

a)  The current social distancing rule of 2m 

b)  Wear a face mask when loading and unloading the vessel 

                                                                                                                                        YES / NO

2)  Have you experienced any of the following symptoms within the last 14 days?

                                                                                                                                        

a)  Fever (temperature>38C) 

b)  Persistent cough

c)  Difficulty breathing 

d)  Loss of taste 

                                                                                                                                     YES / NO

3)  Are you currently under any self isolation/quarantine as prescribed by a doctor or public health authority?                                                                                                                    YES / NO

 

4)  In the past 14 days, have you had any close contact with a person who has been diagnosed with COVID‐19, or is pending a test result or anyone exhibiting the symptoms above?                                                                                                    

                                                                                                                                      YES / NO 

(Close contact means having cared for or having lived with) 

 

The current medical recommendations from the Diver Alert Network (DAN) 

• Divers who have tested positive with COVID-19 but have remained completely asymptomatic, should wait ONE month before resuming diving. 

• Divers who have had symptomatic COVID-19, should wait at least THREE months before applying for fit-to-dive clearance conducted by a diving medicine specialist. 

• Divers who have been hospitalised with or because of pulmonary symptoms in relation to COVID-19, should wait at least THREE months before applying for fit-to-dive clearance conducted or coordinated by a diving medicine specialist, with complete pulmonary function testing (at least FVC,FEV1, PEF25-50-75, RV and FEV1/FVC, and an exercise test with peripheral oxygen saturation measurement) as well as a high resolution CT scanning of the lungs. 

• Divers who have been hospitalised with or because of cardiac problems in relation to COVID-19, should wait at least THREE months before applying for fit-to-dive clearance conducted or coordinated by a diving medicine specialist with cardiac evaluation, including echocardiography and exercise test (exercise electrocardiography). 

 

5) Do you consider yourself fit to dive?      YES / NO 

        
I confirm that I have answered the above to the best of my knowledge 

Name (Print): __________________________


Signature:  _______________________________

 

Date:  __________________

 

Additional information required for diving 

 

Diving Qualification:  ___________________________________


Breathing GAS:   ____________________


Emergency contact name and phone number:      __________________________________

 

Age:  __________


Planned maximum dive time:      ___________________________________