Shore Diving Risk Assessment
Complete this form to evaluate shore dive readiness, site conditions, equipment preparedness, and overall risk before the dive.
Diver Profile and Experience
Full Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Certification Level
*
Beginner/Open Water
Advanced Open Water
Rescue Diver
Instructor
Other
Total Logged Dives
*
Shore Dives Completed
*
Last Dive Date
*
-
Month
-
Day
Year
Date
Medical and Fitness Self-Check
Have you had any recent illness that could affect diving?
*
No
Yes
Which current conditions are you experiencing?
Ear or sinus issues
Respiratory problems
Dizziness or fatigue
Injury or pain
Medication that may affect diving
None of the above
Do you currently have any ear or sinus equalization issues?
*
No
Yes
Do you currently have any breathing or respiratory problems?
*
No
Yes
How fit do you feel for diving today?
*
Not fit to dive
1
2
3
4
5
6
7
8
9
Fully fit to dive
10
1 is Not fit to dive, 10 is Fully fit to dive
Please disclose any other condition or concern that may affect your diving fitness
Dive Plan and Shore Entry Conditions
Dive Location / Site Name
*
Planned Dive Date
*
-
Month
-
Day
Year
Date
Expected Water Entry Type
*
Sandy beach
Rocky shore
Jetty
Surf entry
Other
Planned Maximum Depth
*
Planned Bottom Time
*
Expected Current Strength
*
Calm
1
2
3
4
5
6
7
8
9
Strong
10
1 is Calm, 10 is Strong
Surf / Wave Conditions
*
Calm
Light surf
Moderate surf
Heavy surf
Surging
Other
Visibility Estimate
*
Excellent
Good
Fair
Poor
Very poor
Water Temperature
*
Equipment and Support Readiness
Critical gear status
*
Rows
Ready
Not ready
Needs inspection
Bringing backup
Mask
1
2
3
4
Snorkel
5
6
7
8
Fins
9
10
11
12
Wetsuit/Drysuit
13
14
15
16
BCD
17
18
19
20
Regulator
21
22
23
24
Weights
25
26
27
28
Tank
29
30
31
32
Dive computer
33
34
35
36
Surface marker buoy
37
38
39
40
Whistle or audible signaling device
41
42
43
44
Backup light (if night/low-light is planned)
45
46
47
48
Buddy available for the dive
*
Yes
No
Guide or instructor supervision
*
Yes
No
Shore support on site
*
Yes
No
Transport and gear carry constraints
None
Minor
Moderate
Major
Other
Support needs or limitations
Assistance carrying gear
Vehicle access to entry point
Staging area needed
Tank handling help
Surface support/spotter
Emergency oxygen available
Other
Primary entry support method
Self-carry
Vehicle drop-off
Shore trolley/cart
Boat-assisted shore support
Other
Exit support method
Self-exit
Assisted exit
Rope/ladder support
Vehicle pickup nearby
Other
Tank filled and secured
*
Yes
No
Not applicable
Dive computer battery status
*
Full
Adequate
Low
Unknown
Surface signaling gear carried
*
Yes
No
Partial
Night or low-light backup light planned
Yes
No
Not applicable
Emergency Preparedness and Risk Summary
Nearest Emergency Contact Name
*
First Name
Last Name
Nearest Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Planned Exit Strategy or Pickup Point
*
Overall Shore Diving Risk Assessment
*
Low Risk
1
2
3
4
5
6
7
8
9
High Risk
10
1 is Low Risk, 10 is High Risk
Recommended Dive Decision
*
Proceed
Proceed with Caution
Do Not Dive
Notes and Recommendations
Submit Assessment
Should be Empty: