Medical certificate format 2025

1. Click ‘Get Form’ to open the medical certificate format in the editor.
2. Begin by filling out the 'A. PERSONAL INFORMATION' section. Enter your identification type, ID number, date of birth, gender, family name, first and middle name, registered address, and nationality.
3. Proceed to 'B. SERVICE ON BOARD'. Specify your position on board and department (Deck, Engine, or Other). Indicate if you are part of the navigational watch and any safety functions.
4. In 'C. SELF-DECLARATION AND CONSENT TO COLLECT MEDICAL INFORMATION', answer each health condition question honestly. If you answer 'Yes' to any conditions, provide additional details as required.
5. Complete the 'D. MEDICAL EXAMINATION' section by entering results for visual acuity, hearing tests, clinical findings including height and weight, and any relevant medical reports.
6. Finally, in 'E. DECISION', based on your self-declaration and examination results, indicate your fitness status and any restrictions or limitations applicable.

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