Get Physical Examination Reportcertificate - Liscr

Completing the PHYSICAL EXAMINATION REPORT/CERTIFICATE - Liscr is a vital step for applicants seeking maritime certification. This guide will provide a clear and concise process for filling out the form online, ensuring accuracy and adherence to requirements.

Follow the steps to complete the form accurately.

1. Click the ‘Get Form’ button to access the PHYSICAL EXAMINATION REPORT/CERTIFICATE. This will open the document in a user-friendly online format for easy completion.
2. Begin by entering the applicant's last name, first name, and middle initial in the designated fields. Ensure that the names are correctly spelled to avoid any issues with processing.
3. Fill in the date of birth and place of birth, ensuring that the format is consistent with the guidelines (month/day/year). Indicate the city of birth clearly.
4. Specify the gender by selecting either 'male' or 'female.' This information is essential for the examination report.
5. Complete the mailing address section of the applicant. This information will be used for any correspondence regarding the examination results.
6. Select the examination type for duty by checking the appropriate box (master, mate, engineer, radio officer, rating). Ensure that you choose the correct duty role.
7. For medical details, report the height, weight, blood pressure, pulse, and respiration. Be accurate, as these measurements are critical to the examination.
8. Document the vision details for both the right and left eyes, including whether glasses are used. This includes noting any discrepancies noticed during the examination.
9. Note the general appearance and hearing assessment results for each ear. Check if the color test is normal or provide details if not.
10. In the section regarding health conditions, answer if the applicant is suffering from any disease that might affect their fitness for duty. This ensures that safety is prioritized.
11. The applicant must sign and date the form in the presence of the examining physician, ensuring the signature is legible.
12. The examining physician completes their section by confirming whether the applicant is fit or not fit for their respective duties. This must include their name, degree, address, and signature.
13. Once all sections are filled out accurately, review the document for any errors. After confirming that all information is correct, proceed to save your changes, download a copy, print, or share the form as needed.

Complete your PHYSICAL EXAMINATION REPORT/CERTIFICATE - Liscr online today to ensure a smooth application process for your maritime duties.