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Get Coast Guard Medical Certificate Form Pdf
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How to fill out the Coast Guard Medical Certificate Form Pdf online
Filling out the Coast Guard Medical Certificate Form Pdf is a crucial step for individuals seeking merchant mariner credentials. This guide provides a detailed, step-by-step approach to assist users in completing the form accurately and efficiently online.
Follow the steps to fill out your form with ease.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin with Section I, where you will input your personal information including your full name, date of birth, and social security number. Ensure that all details are accurate to facilitate your application process.
- In Section II, provide your authorization for the verifying medical practitioner to release necessary medical information to the Coast Guard. This is important for the assessment of your medical eligibility.
- Progress to Section III, where you will report all medications, including prescription, over-the-counter drugs, and supplements taken within the last 90 days. Make sure to include dosages and the conditions for which each substance is used.
- In Section IV, list any medical conditions to the best of your knowledge. Each condition may need a detailed description, including diagnosis dates and current status. The verifying medical practitioner will also review this section.
- Sections V to VII involve the verifying medical practitioner conducting examinations of your vision, hearing, and overall physical health. Ensure this practitioner is qualified and familiar with the guidelines.
- For Section VIII, a demonstration of your physical ability may be required. The verifying medical practitioner will assess this according to the tasks relevant to maritime duties.
- Finally, review all entered information for accuracy and completeness. Once satisfied, you can save your changes, download the completed form, and either print or share it as required.
Start filling out your Coast Guard Medical Certificate Form Pdf online today to ensure your maritime service credentials are up to date.
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 in the subject line.