MMC Physical form 719K

On this page help is provided for two USCG forms. Firstly, MMC Physical form 719K. And then the MMC Drug Screening form 719P.

MMC Application form 719K MMC Physical form 719K

Every Merchant Mariner Credential application must include the form 719K Application for Medical Certificate. However, there is an exception. Mariners with a valid medical certificate may use a copy of of that certificate in place of this form.

Firstly, do not remove the first two pages of instructions from the form. The mariners name and birthdate, as well as the medical persons initials must be on each page. Secondly, many pages include instructions, such as; to be completed by applicant and reviewed by medical person. Following these instructions helps the medical person and helps the exam go quicker.

MMC Physical form 719K Section I Applicant Information

The top part of this section is personal information. The bottom part labeled Endorsement Held or Sought has several boxes. In is important to check the correct box or boxes. Since the Master, Mate, OUPV, and AB are all deck endorsements, check the Deck box.

MMC Physical form 719K Section III(a) Medical Conditions

The applicant will complete this section and review it with the medical person. Read the instructions at the top of this section. And then read each medical condition carefully and answer according to the instructions. Lastly, for any condition that you answer YES to the Medical person should address that condition in Section III(b).

MMC Physical form 719K Section IV Medications

When you list the medications you are taking, include the conditions from Section III that you may be taking them for.

Section IX Summary and Section X Applicant Certification

When the medical person signs the form check to that they included their license and contact info. Secondly, the applicant must also sign this form.

MMC Application form 719P MMC Drug Screening form 719P

While most MMC applications require drug screening; the use of form 719P DOT/USCG Drug Screening is optional. The important part of this form is on page 2, which includes three options for meeting the drug screening requirements.


In conclusion, if you have any questions that are not answered please contact us. Remember, our business is helping mariners. Selling courses is just what we do to stay in business.

Additional application form help pages.

MMC Application form 719B

Small Vessel Sea Service form 719S