Dive Medical Booking Form

Please complete the form below to book a dive medical with the Midlands Diving Chamber. Alternatively, you can arrange one by calling MDC on 01788 579 555.

Normal appointment times are:

Wednesday and Thursday 9.30am - 4.00pm

Tuesday 9.00am - 4.00pm

However we may be able to accommodate other times on specific request.

Please Note: We are unable to arrange routine dive medicals at weekends.

Appointments usually take about half an hour except for the HSE Preliminary, BR1750A Military Medical and the Full Health Screening, all of which require about an hour.

We will e-mail you back with directions and confirming the time and date of your appointment:

First name*

Last name*

Telephone*

Email*

Preferred Appointment Date*

Preferred Time*

Alternative Date*

Alternative Time*

Appointment Type*

Further Details

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