MEDICAL QUESTIONS:

• Do you currently have an ear infection?
• Do you have a history of ear disease, hearing loss or problems with balance?
• Do you have a history of ear or sinus surgery?
• Are you currently suffering from a cold, congestion, sinusitis or bronchitis?
• Do you have a history of respiratory problems, severe attack of hay fever or allergies, or lung disease?
• Have you had a collapsed lung (penumothorax) or history of chest surgery?
• Do you have active asthma or history of emphysema or tuberculosis?
• Are you currently taking medications that carries a warning about any impairment of your physical or mental abilities?
• Do you have behavioral health problems or a nervous system disorder?
• Are you or could you be pregnant?
• Do you have a history of colostomy?
• Do you have a history of heart disease or heart attack, heart surgery or blood vessel surgery?
• Do you have a history of high blood pressure, angina, or take medication to control blood pressure?
• Are you over 45 and have a family history of heart attack or stroke?
• Do you have a history of bleeding or other blood disorders?
• Do you have a history of diabetes?
• Do you have a history of seizures, blackouts or fainting, convulsions or epilepsy or take medications to prevent them?
• Do you have a history of back, arm or leg problems following an injury, fracture or surgery?
• Do you have a history of fear of closed or open spaces or panic attacks (claustrophobia or agrophobia)?