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The document is the Application for Medical Certificate (Form CG-719K) issued by the U.S. Coast Guard, detailing the requirements and procedures for mariners seeking a medical certificate. It outlines who must submit the form, who can conduct medical examinations, and provides sections for applicant information, medical conditions, medications, physical examinations, vision and hearing tests, and consent for information release. The form emphasizes the importance of accurate reporting of medical history and conditions to ensure compliance with maritime health standards.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (107 Votes)
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2002	4.4 Satisfied (186 Votes)

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Who can perform a Coast Guard physical?

The medical provider completing the required examination must be a physician, physician assistant, or nurse practitioner who is licensed in the U.S. or a U.S. territory.

Can any doctor do a Coast Guard physical?

You can obtain your physical examination at a doctors office. A qualified physician, physician assistant, or nurse practitioner can complete and record their findings on Form CG-719K. Ensure that the medical professional conducting the exam is familiar with the specific requirements for Coast Guard credentials.

How long does it take to get a USCG medical certificate?

In direct correspondence, the Coast Guard has stated it may take up to 90 days for an application to be reviewed and for a Medical Certificate to be issued after Form 719K or Form 719K/E has been sent by e-mail or by FAX to 304-433-3407. Applications are processed by the Coast Guard on a first-in, first-out basis.

What disqualifies you from getting an MMC?

Reason: Criminal convictions, especially those involving moral turpitude, assault, or theft, can affect a mariners MMC. The Coast Guard reviews convictions carefully, particularly if they occurred while on duty or involved alcohol, drugs, or violence.

How long are Coast Guard physicals good for?

(1) Every five years, in ance with the medical certificate requirements in 10.301(b), 10.302(a), and 10.304(d) of this chapter, the results of the most recent physical examination must be submitted to the Coast Guard.

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How much does the Coast Guard physical cost?

USCG Physical Exam - $125 The U.S. Coast Guard requires that a Physical Examination Certificate be completed to ensure that all holders of Captains Licenses and Merchant Mariners documents are physically fit and free of debilitating injury.

What is a cg 719K form?

CG 719K. The Application for Mariner Medical Certificate (CG-719K) is required for Officers and Mariners with a qualified rating. The examination and form must be completed within 12 months of application date.

Does the Coast Guard have medical doctors?

Through a combination of direct employment and partnership with the U.S. Public Health Service (USPHS), the Coast Guard employs board certified/board eligible primary care physicians who are typically residency-trained in family medicine, internal medicine, or emergency medicine.

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Who can perform a Coast Guard physical?

Can any doctor do a Coast Guard physical?

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How long are Coast Guard physicals good for?

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