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Click ‘Get Form’ to open the CG 719K in the editor.
Begin with Section I: Applicant Information. Fill in your legal name, date of birth, and contact details. Ensure that your home address is accurate, as this will be used for correspondence.
Proceed to Section II: Food Handler Certification. This section must be completed by your Medical Practitioner, who will attest to your health status regarding communicable diseases.
In Section III: Medical Conditions, report any relevant medical history. Check 'YES' for conditions you have been diagnosed with or treated for. Your Medical Practitioner will review this information.
Complete Section IV: Medications by listing all medications you are currently taking. Your Medical Practitioner will verify this information.
Sections V through IX require input from your Medical Practitioner regarding physical examinations and assessments. Ensure they initial and date each page as required.
Finally, review Sections X and XI for applicant certification and optional consent forms before submitting the completed document.

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