If you have any medical issues that may prevent you from qualifying for a license than it is highly recommended that you apply for the medical certificate BEFORE taking the class. The doctor must sign, and included their license, and contact info. Section IX Summary and Section X Applicant Certification Lastly, the rest will be completed by the doctor. List your meds, and then review them with the doctor. Secondly, for any condition that you answered YES to, the doctor must discuss it in Section III(b). Most important: Read the instructions at the top. Section III(a) Medical ConditionsĬomplete this section, and then review it with the doctor. Check the Deck box only to apply for OUPV, Master, Mate, AB, or OS. The bottom part labeled, Endorsement Held or Sought, has several boxes. Section I Applicant Infoįill-in your personal info in the top part. And then, review your answers with the doctor. Therefore: Answer these questions BEFORE the physical. Secondly: the mariners name and birthdate, and the doctors initials, must be on each page.Īnd thirdly, many pages state: to be completed by applicant and reviewed by medical person. MMC Physical form 719K Helpįirstly: do not remove the first two pages of instructions from the form. However, mariners with a valid medical certificate, may use a copy of that certificate in place of this form. And secondly, the MMC Drug Screening form 719P.Įvery MMC application must include form 719K Application for Medical Certificate. On this page help is provided for two USCG forms.
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