Background: Qualified health surveillance in aquatic sports is imperative for athlete care and training guidance. Several tools have been proposed for athlete health surveillance across different sports, including the questionnaire "Prospective aquatic athlete health surveillance throughout the season", developed by an expert committee from World Aquatics (former FINA). However, this tool had not been culturally adapted to the Brazilian context, which still lacks a validated health surveillance tool for aquatic sports. Mental health monitoring items, absent from several surveillance instruments, were later addressed by a supplementary questionnaire developed by the International Olympic Committee. Aim: To adapt and unify the questionnaires Prospective aquatic athlete health surveillance throughout the season and Mental health problems for the Brazilian context. Methods: A methodological study was conducted following established cross-cultural adaptation procedures, including initial translation, reconciliation, back-translation, expert committee review, and final adjustments. The supplementary Mental health problems questionnaire proposed by the International Olympic Committee was culturally adapted following the same procedure. Content validity was assessed using the Content Validity Coefficient (CVC) for clarity, theoretical relevance, and practical relevance. Results: All items from the aquatic health surveillance questionnaire showed satisfactory content validity coefficients, with mean values ranging from 0.90 to 1.00. In the mental health supplementary questionnaire, most items also showed satisfactory coefficients, ranging from 0.88 to 0.96 after expert discussion and final semantic adjustments. Specific modifications were required to preserve conceptual equivalence in terms such as performance anxiety, alcohol misuse, and gender dysphoria. Conclusions: The Brazilian version of the integrated aquatic athlete health surveillance tool showed satisfactory initial evidence of content validity and expands weekly health monitoring by incorporating mental health indicators
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