The Coast Guard is planning to release new versions of the Merchant Mariner Credential Medical Evaluation Report form (CG-719 K) and the Merchant Mariner Evaluation of Fitness for Entry Level Ratings form (CG-719 K/E). These new forms will be phased in over a two month period, as outlined below. The CG-719 K/E should be used only by mariners seeking an entry level credential. This form is limited to applicants for the following rating endorsements: Ordinary Seaman, Wiper, or Steward’s Department (food handler). The CG-719K should be used for all other endorsement applications.

 These forms are designed to work in conjunction with the policies set forth in the MEDICAL AND PHYSICAL EVALUATION GUIDELINES FOR MERCHANT MARINER CREDENTIALS, Navigation and Vessel Inspection Circular (NVIC) 04-08. The forms will assist medical practitioners with obtaining objective medical information about an applicant’s physical condition as it relates to their ability to perform duties as a merchant mariner. To prevent delays in processing credential applications, applicants and medical practitioners are highly encouraged to follow the guidance in the NVIC when completing the new forms during a medical examination. This is particularly important for applicants with medical conditions or who are taking prescription medications.

 Implementation Timeline:

                        November 2, 2009 to December 31, 2009 VOLUNTARY USE PHASE – The new forms will be available on the NMC website on November 2, 2009 for familiarization and optional use. NMC will also post a printable Instruction Guide and forms that can be completed on line, which will include embedded electronic instructions to assist both the mariner and medical practitioners in completing the forms.

                        January 1, 2010 – BEGIN MANDATORY USE – The previous version of forms 719K and K/E will no longer be available for use on January 1, 2010. Physical exams completed on or after January 1, 2010 must be documented on Revision (01/09) of the 719 K or K/E.

 For questions about the use of the new forms, please contact the NMC by email at or by phone at 1-888-IASKNMC.