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Items 1 - 17 - required to submit this form if a previous medical evaluation report has not been ... The Coast Guard requires a physical examination and certification be ... Guidelines for Merchant Mariner
CG-719K/E (01/14) ... guardian, authorizing the Coast Guard to issue a Medical Certificate. ... medical and physical evaluation guidelines for merchant mariner credentials is contained in Navigation and
Department of Transportation. U.S. Coast Guard. OMB-2115-0514. CG-719K (Rev 1/02). Merchant Mariner Physical Examination Report. Page 1. Instructions.
determination as to whether the Coast Guard should issue me a medical certificate for maritime service. ... CG-719K (06/12) .... (d) Refer to Medical and Physical Evaluation Guidelines for Merchant ...
Items 1 - 17 - MUST use form CG-719K with Exp 1/31/2016. ... required to submit this form if a previous medical evaluation report has not ... The Coast Guard requires a physical examination and certification
Sep 15, 2008 - Coast Guard practices with respect to the physical and medical evaluation process have ... this NVIC to ensure a complete and appropriate physical exam is conducted. .... Applicants for
Page 4: Application for License (CG 719B) instructions ... Form CG719K Physical Examination Report (must have been completed ... Forms referenced in this checklist are included in this packet but may also
Have your PCP complete the United States Coast Guard form CG-719K ... by your healthcare provider in addition to the CG-719K physical exam form ... Does the patient report any palpitations or irregular