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Bioastronautics: IVA Space Suit Evaluation
Bioastronautics: EVA Space Suit Evaluation
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The IIAS Astronautical Science Program
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2024 Class Schedule
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Home
Educational Programs
Fundamentals of Astronautics at Florida Tech
Professional Certificates
Aeronomy
Bioastronautics: IVA Space Suit Evaluation
Bioastronautics: EVA Space Suit Evaluation
Space Flight Operations
Flight Test Engineering
The IIAS Astronautical Science Program
Short Courses
All Courses
2024 Class Schedule
Research
Aeronomy
Bioastronautics Research
Microgravity Research
Space Medicine
Spaceflight Research
About
Mission Statement and Core Values
Educational Philosophy
Our Team
Our Directors
Our Instructors
Our Advisors
Our Partners
Our Facilities
Sponsored Outreach Programs
Press
IIAS Bookstore
Donate
Contact
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Medical History
Health Questions
These are the health questions to be answered by the participants.
Important Notice and Disclaimer
Spacesuits, unusual attitude flight, and high-altitude training administered during an IIAS course may expose participants to gravitational forces (G-forces), motions, and simulated altitudes similar to those experienced during actual flight which may cause some individuals to experience symptoms of motion sickness, altitude sickness, claustrophobia and/or other disorientating effects. Persons having any health concerns regarding their suitability to participate in IIAS activities should obtain physician’s approval, since neither Project PoSSUM, Inc, the International Institute for Astronautical Sciences, Integrated Spaceflight Services LLC, nor any of its partner organizations, does not assume any responsibility in this regard. Please check all that apply.
Ositis, sinusitis, bronchitis, asthma, or other respiratory disorders
*
Yes
No
Dizziness or vertigo.
*
Yes
No
Fainting spells, or any other loss of consciousness
*
Yes
No
Seizures
*
Yes
No
Tuberculosis
*
Yes
No
Recent significant trauma (broken bones, concussions, poisonings, etc.)
*
Yes
No
History of decompression syndrome (DCS)
*
Yes
No
Anemia or other blood disorders
*
Yes
No
Heart or circulatory disorders, implanted devices, stents
*
Yes
No
Mental disorder, treatment or medications for depression
*
Yes
No
Claustrophobia
Yes
No
Alcohol or drug dependence or abuse
*
Yes
No
Currently pregnant, or recently post-partum (less than 6 weeks), or if you have recently spontaneously or voluntarily terminated a pregnancy
*
Yes
No
Diabetes
*
Yes
No
Cancer
*
Yes
No
Acid Reflux disorder, treated or untreated
*
Yes
No
Borderline Hypertension, treated or untreated
*
Yes
No
Surgery and other hospital admissions within the past 5 years
*
Yes
No
Please state reason for surgery or hospital admission.
Visits to physicians (other than regular checkups & physicals) in the last 3 years
Yes
No
Please state reason for physician visit
Previously attempted suicide
*
Yes
No
Use of prescription medications
*
Yes
No
Please list medications
Previously rejected for life or health insurance
*
Yes
No
Please state the reason why you were rejected.
Please enter your height (in inches)
*
Please enter your weight (in pounds)
*
PARTICIPANT MUST MEET THESE PHYSICAL REQUIREMENTS FOR SPACESUIT AND HIGH-G INSTRUCTION
Maximum Height: 6’7” or 77 inches (196cm)
Minimum Height: 5’0” or 60 inches
Max Weight: 240 lbs. (141kg)
MEDICAL CERTIFICATES
PoSSUM Activities require a valid FAA Medical 3rd Class Certificate (Form 8500-8) or NASA JSC Form 708. Participants originating from outside the US may submit an equivalent aviation medical certificate. To obtain a medical certificate in the US, find a local FAA Aeromedical Examiner near you: www.faa.gov/pilots/amelocator/ These typically cost between $75 and $100. If you do not pass, ask the AME physician for the copy of your FAA Form 8500-8 (front and back) paperwork with a written explanation indicating why you did not pass. An Integrated Spaceflight aerospace physician will evaluate the paperwork and inform you if you can still participate.
*
I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
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Last
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