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Medical examination certificate 2026
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- Click ‘Get Form’ to open the medical examination certificate in our editor.
- 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.
- Fill in the date of birth and place of birth, followed by the applicant's sex. Select either 'Male' or 'Female' as appropriate.
- Provide the mailing address of the applicant, ensuring all details are correct for future correspondence.
- Indicate the examination purpose by selecting from options such as Master, Mate, Engineer, Radio Officer, or Rating.
- Complete the medical details section including height, weight, blood pressure, pulse, respiration rates, and vision tests for both eyes.
- Answer questions regarding general appearance and hearing capabilities. Ensure to check if color perception is normal.
- 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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medical examination certificate
Medical Examiners Certificate Form, (MEC) MCSA-5876. These forms need to be completed by a United States (U.S.) licensed doctor of medicine (M.D.), licensedRead more
Federal regulations require that all Medical Examiners Certificates and/or Medical Variances be sent electronically to the National Registry and then to DMV.Read more