GREAT BRITAIN DIVING FEDERATION
MEDICAL INFORMATION FORM
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Email *
EVENT
GBDF Spring Masters, Royal Commonwealth Pool, Edinburgh
Name *
Diving Club/Group/Independent *
Blood Group (n/a if unknown) *
Date of Birth
MM
/
DD
/
YYYY
Emergency Contact Name *
Emergency Contact Number *
Doctor's Name
Doctor's Phone Number
Please detail any relevant injuries or ailments, and any past relevant medical history e.g. asthma, blood pressure, heart conditions, back issues, etc. *
Please list any allergies (n/a if none) *
Please give details of any medication that is currently being taken
This information is confidential and only applies to the event shown above.  It will be destroyed after the event has finished.
A copy of your responses will be emailed to the address you provided.
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