Get Annex 17 Doctors Prescribed Form Memo

Filling out the Annex 17 Doctors Prescribed Form Memo online is crucial for candidates needing to demonstrate their fitness to operate a small vessel. This guide provides a clear and systematic approach to completing each section of the form to ensure it meets necessary requirements.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to access the document and open it in your editor.
2. In the 'Particulars of Candidate' section, fill in the first names, surname, ID number, and address of the candidate. Ensure all information is correct and matches the identification provided.
3. Proceed to the 'Eyesight Test' section. Candidates will need to have their eyesight assessed by a doctor or optometrist, who will complete the results of the letter test and the Ishihara card test, marking 'PASS' or 'FAIL' as applicable.
4. The examining medical practitioner needs to provide their signature and printed name, along with their contact telephone number and the date of examination. Make sure the address of the practice is also included.
5. In the 'Medical Certificates' section, the doctor will confirm the candidate's physical and mental ability to operate a small vessel by selecting the appropriate fitness level and adding any relevant comments.
6. The doctor must sign and print their name, date of examination, and provide their contact number and practice address to finalize the medical declaration.
7. After completing the form, review all entries for accuracy. You can then save changes, download, print, or share the finalized form.

Complete your documents online confidently and efficiently.