Medical form


Before taking part in the in-water portion of any PFI course, you must complete, sign and submit the standard Medical History form to your instructor.

  • If you can honestly answer No to all of the questions on the form, this is all your instructor may require.
  • If you answer Yes to any question, you must obtain a physician’s approval and he or she must sign where indicated on the back of the form.
  • Students in any leadership-level PFI course must obtain a physician’s approval regardless.

Completing the form

The form is an Adobe Acrobat PDF. You may:

  • Open the form in Adobe Acrobat and type in the required information before printing it. Be aware to do this, you must open the form only in the standalone Acrobat app; if opened in your web browser, you will not be able to save any changes you make.
  • Print a blank copy of the form and complete and sign it by hand.


  • If you answer a question incorrectly while completing the form by hand, you must start over using a blank form. Crossing out or whiting out an answer invalidates the form.