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Maine Medical Center Appendix D1 Health Screening Form (page 1 of 2) Dear Healthcare Provider Re: Your patient Maine Medical Center's (MMC) policy requires all persons to be medically screened for.

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The Application for Merchant Mariner Medical Certificate for Entry Level Ratings (CG-719K/E) is required for entry level mariners. The examination and form must be completed within 12 months of application date.

→ The Application for Mariner Medical Certificate (Form CG-719K). This form is required for Officers and Mariners with a qualified rating. → The Application for Merchant Mariner Medical Certificate for Entry Level Ratings (Form CG-719K/E). This form is required for entry level mariners.

How do I submit an application? For a medical certificate only, the preferred way to submit your CG-719K or CG-719K/E (medical certificate applications) along with any supplemental medical information is via e-mail to MEDAIP@uscg.mil. Please include your full name and reference number in the subject line.

Top 5 Medical Conditions that might delay mariner applications if not disclosed Cardiovascular Conditions. Seizure Disorders. Psychiatric Disorders. Sleep Disorders. Chronic Use of Impairing Medications.

The preferred method to submit your Medical Certificate application including all required application documents is via e-mail to: MEDAIP@uscg.mil. Please include your full name in the subject line.

All application packets must be submitted to a Regional Exam Center (REC). The REC will then forward your submission to the NMC for evaluation and issuance. Once your paperwork has been logged, you will receive an email with your Merchant Mariner Credential (MMC) reference number and application tracking number.

NPT is the total time the Coast Guard spends processing the application and does not include the time waiting for information from mariners. The NMC has set a NPT goal of 20 days. Medical Certificate throughput is a ratio of the total number of applications finished divided by the total number of applications received.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232