If, when you completed the 'Medical Self Assessment' above, you answered 'Yes' to questions 3, 5 or 10, OR any questions in Boxes A-G, then please take a signed print out of the above 'Medical Self Assessment' & 'Physician's Evaluation Form' below, to your Physician for clearance. (This can be downloaded & emailed or printed).

DiverMojo LLC

2841 N Ocean Blvd, Suite 1706, 
Fort Lauderdale, Florida, 33308 
United States 

+1 919-697-5837

© 2021 DiverMojo LLC — All Rights Reserved 

Florida Seller of Travel Ref. No. ST41857