Get Cg 719k 2013 Form

Filling out the Cg 719k 2013 Form online can be a straightforward process if you follow the provided guidance. This form is essential for applicants seeking a merchant mariner credential medical evaluation, and completing it accurately is crucial.

Follow the steps to fill out the Cg 719k 2013 Form online.

1. Press the ‘Get Form’ button to download the form and open it in your preferred online editor.
2. Begin by completing Section I, which includes your personal information such as last name, first name, middle name, date of birth, and social security number. Make sure to double-check for accuracy.
3. In Section II, provide authorization for the verifying medical practitioner to release any relevant medical information to the Coast Guard.
4. Move to Section III to list all medications you are currently taking or have taken in the last 30 days. Be thorough and ensure that dosages and the purpose of each medication are included.
5. Complete Section IV, where you need to certify any medical conditions you have experienced. The verifying medical practitioner will review and verify this information.
6. Proceed to Section V to provide your visual and hearing test results if applicable, which must be completed by the verifying medical practitioner.
7. In Section VI, the verifying medical practitioner will indicate whether you meet the hearing requirements, so follow up with them for this information.
8. Complete Section VII, where the verifying medical practitioner will document your physical examination results.
9. If required, follow the instructions in Section VIII for demonstrating physical ability. This may involve specific physical tasks that will assess your capabilities.
10. Finally, ensure that the verifying medical practitioner signs and dates the form in Section IX, attesting to the accuracy of the information provided.
11. Once all sections are completed, you can save the changes, download the completed form, print it out, or share it as needed.

Start the process of filling out your form online today.