MMC Physical form 719K

MMC Physical form 719K

MMC Physical form 719K

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

Every MMC application must include form 719K Application for Medical Certificate. However, mariners with a valid medical certificate, may use a copy of that certificate in place of this form.

MMC Physical form 719K Help

Firstly: do not remove the first two pages of instructions from the form.

Secondly: the mariners name and birthdate, and the doctors initials, must be on each page.

And thirdly, many pages state: to be completed by applicant and reviewed by medical person. Therefore: Answer these questions BEFORE the physical. And then, review your answers with the doctor.

Section I Applicant Info

Fill-in your personal info in the top part.

The bottom part labeled, Endorsement Held or Sought, has several boxes. Check the Deck box only to apply for OUPV, Master, Mate, AB, or OS.

Section III(a) Medical Conditions

Complete this section, and then review it with the doctor. Most important: Read the instructions at the top.

Secondly, for any condition that you answered YES to, the doctor must discuss it in Section III(b).

Section IV Medications

List your meds, and then review them with the doctor.

Lastly, the rest will be completed by the doctor.

Section IX Summary and Section X Applicant Certification

The doctor must sign, and included their license, and contact info.

You must also sign this form as well.

In conclusion. If you have any medical issues that may prevent you from qualifying for a license than it is highly recommended that you apply for the medical certificate BEFORE taking the class. Click here for more info on how to apply for a medical certificate >>

DOT / USCG Drug Screening

Most MMC applications require drug screening. The use of form 719P DOT/USCG Drug Screening is optional. But. there are options on page 2.


Read and follow the instructions. And then if you have any questions please contact us. Above all, our business is helping mariners. However, selling courses is what we do to stay in business.

More help

Get the USCG form 719K

Get the USCG form 719P

Help with MMC Application form 719B

Help with sea service experience

View all USCG forms on the NMC website

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