Investigating the space between

Non-divers

If you would like to help by taking part in one of our studies, then please fill out the form below and CLICK "Proceed" : NONE of your information will be passed onto third parties, all information is treated in the strictest of confidence and is entirely anonymous. If you have any questions, feel free to contact me.

Email Address:
First Name:
Surname:
Age at time of completing this questionnaire?
Gender?	Male / Female
Do you live in South West region of England and are happy to take part in further research?	Yes / No

Thank you. It is hoped that this information will allow the researchers to investigate if there are any differences between divers based on their previous diving. The next few questions are related to your health and lifestyle, once again please remember that the information given here is confidential and will only be used for comparative purposes.

Education

At what age did you leave formal education?

Years Old

General Health Checks:

For each of the following medical conditions, please indicate whether they apply to you by clicking yes or no.

		Additional details:
Heart Attack	Yes / No
Other Heart Problems	Yes / No
Stroke	Yes / No
Diabetes	Yes / No
Epilepsy	Yes / No
Operation in the last year?	Yes / No
More than 3+ operations in lifetime?	Yes / No
Taking Prescribed Medication	Yes / No
Significant head injury	Yes / No
Depression	Yes / No
Would you consider yourself a regular drinker?	Yes / No

Decompression Illness
Have you ever been treated for a Decompression Illness in a chamber?	Yes / No

Thank you once again.

The following page has a 25-item questionnaire which should take less than 10 minutes to complete. The aim of this questionnaire is to enable us to make a comparison between divers with 20+ years experience and various other populations. The research team are aware of anecdotal evidence where divers have reported that they believe themselves to be different in certain ways from non-diving friends or relatives. There will be an opportunity after the questionnaire for you to add any comments that you feel may be relevant.