RIA General Health Questionnaire

Private pilot, scuba/skin diving, organized motor vehicle racing (i.e. snowmobile or motorboat), skydiving, hang gliding, mountain climbing, or rodeo?
Traveled outside the U.S. or Canada? Any future plans to travel abroad?
Been in an auto accident, convicted of a driving while intoxicated, or have more than two moving violations?
Been on parole or probation or convicted of a felony or misdemeanor?
Regularly used or are you currently using marijuana or other controlled substances?
Ever been medically advised to limit or discontinue the use of alcohol or drugs, or sought or received treatment?
None of the above

Applicant Information