October 30, 2009

Today the Coast Guard is releasing revised versions of the Merchant Mariner Credential Medical Evaluation Report form (CG-719 K, Revision 01-09) and the Merchant Mariner Evaluation of Fitness for Entry Level Ratings form (CG-719 K/E, Revision 01-09) to facilitate obtaining objective medical information for use in evaluating merchant mariner credential applications. These forms are now available for voluntary use until December 31, 2009. All physical exams completed on or after January 1, 2010 must be documented on Revision 01-09.

The revised form has been designed to work in concert with the information contained in the Medical and Physical Evaluation Guidelines for Merchant Mariner Credentials, (NVIC 04-08). A complete Medical Evaluation Form is essential for NMC to process an application in a timely manner. To assist mariners and the Verifying Medical Practitioner (VMP) with submitting a complete report form, we are providing a printable Instruction Guide. We are also providing electronic forms that can be completed on line, which will include embedded electronic instructions to assist mariners and medical practitioners with completing the forms.

Mariners with diagnosed medical conditions or who are taking prescription medication should carefully review the information in NVIC 04-08, the Instruction Guide, and the CG-719K or K/E forms. It is highly recommended that mariners bring the Instruction Guide and forms, along with the applicable sections of the NVIC 04-08 that pertain to their specific medical conditions, with them when they have their physical exam so that the medical provider can supply recommended evaluation documentation for any diagnosed medical conditions. This medical documentation should be submitted along with the CG-719 K form at the time of application. The use of the resources being made available should result in less missing information and a faster processing time.

Available Resources on NMC’s official website:

                        Instruction Guide to the Merchant Mariner Credential Medical Evaluation Report (CG-719 K & K/E)

                        Electronic CG-719 K with embedded instructions

                        Electronic CG-719 K/E

For questions on the use of these forms, please contact NMC by using our contact form, select “Medical” in the category drop down, found at http://www.uscg.mil/nmc/contact_iasknmc.asp?Category=Medicalor by calling 1-888-IASKNMC.