Medical examination certificate 2026

1. Click ‘Get Form’ to open the medical examination certificate in our editor.
2. Begin by entering the applicant's last name, first name, and middle initial in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in the date of birth and place of birth, followed by the applicant's sex. Select either 'Male' or 'Female' as appropriate.
4. Provide the mailing address of the applicant, ensuring all details are correct for future correspondence.
5. Indicate the examination purpose by selecting from options such as Master, Mate, Engineer, Radio Officer, or Rating.
6. Complete the medical details section including height, weight, blood pressure, pulse, respiration rates, and vision tests for both eyes.
7. Answer questions regarding general appearance and hearing capabilities. Ensure to check if color perception is normal.
8. The applicant must sign and date the form in front of the examining physician who will also complete their section certifying fitness for duty.

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