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Get Medical Certificate Form
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Open form follow the instructions
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Easily sign the form with your finger
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How to fill out the Medical Certificate Form online
Filling out the Medical Certificate Form online is a straightforward process that can be managed efficiently with careful attention to detail. This guide provides step-by-step instructions to help users complete the form accurately.
Follow the steps to complete the Medical Certificate Form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the examinee's information. Fill in the full name, age, date of birth, sex, passport number, and seafarer's book number. Ensure that all personal details are accurate.
- Proceed to the section regarding the examinee's personal declaration. Answer 'yes' or 'no' to each medical condition listed. If 'yes' is selected for any conditions, provide additional details as required.
- In the medical examination section, ensure that the physician completes the necessary fields regarding sight, hearing, and clinical findings. This includes entering pulse rate, blood pressure, and any other significant medical details.
- Review the assessment of fitness for service at sea. The physician will indicate if the examinee is fit or not, and if there are any restrictions. Ensure the doctor provides their signature and relevant information in this section.
- Final steps involve reviewing all entries for accuracy and completeness before proceeding to save changes. Once satisfied, download, print, or share the form as needed.
Complete your Medical Certificate Form online today for a seamless experience.
Penalties Failing to present a driver's license is an infraction under California Vehicle Code Section 12951 VC that is punishable by a $250 maximum court fine (not including additional penalty assessments).
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