You can download and print Form CG-719K here.
What is the CG-719K form?
Form CG-719K is used during the physical examination.
Where do I go about getting my physical?
You can go to a doctor’s office to get your physical done. A physician, physician assistant, or nurse practitioner who is licensed in the U.S. or a U.S. territory can fill out and record their findings on form CG 719-K. You can also try walk-in clinics or places that do employment physicals.
TIP: Make sure the doctor’s office has equipment to do hearing and visions exams.
What do I select under Section I: Endorsement Held or Sought?
Under Endorsement Held or Sought, you will want to check off Deck. Do not select Other.
How long do I have to get this form completed when applying for the Coast Guard?
This examination and form must be completed within 12 months of application date (36 months if applying for Raise of Grade).
What do I do with the medical certificate when I receive it?
The medical certificate folds in half, to be placed in the plastic sleeve located in the back of your MMC booklet:
- Use a blue or black ballpoint pen to sign your certificate as soon as you receive it
- Do not separate the pages of your certificate
- Note your expiration dates; they coincide with the type of service you are engaged in (STCW, National, or Pilot)
- You are required to keep your certificate in the plastic sleeve at the back of your MMC
- If your certificate indicates that you have a medical waiver, you must comply with the requirements of the accompanying waiver letter
- In addition to a valid medical certificate, the waiver letter must be carried with you when you sail under the authority of your MMC. As a result of the waiver, your certificate may also carry a limited expiration date of 1 or 2 years
CAUTION: Very important - It is not to be taped, glued, laminated, peeled, or detached.
What is the cost of the medical certificate?
There is no cost for a medical certificate. Normal fees still apply to MMC transactions consistent with 46 CFR Table 10.219(a). A medical certificate will not negate nor increase the normal MMC fees.
How do I request a duplicate medical certificate?
Submit your request for a duplicate medical certificate to the National Maritime Center (NMC) via phone (888) 427-5662 or e-mail (IASKNMC@uscg.mil). Your request must include full name, mariner reference number, reason for the request, and desired mailing address.
How long will it take for me to receive my medical certificate from the NMC?
Processing times will vary depending on the medical condition(s) reported and supplemental information provided. If your application is not filled out properly or if we require additional information to complete your evaluation, the processing will be delayed. On average, the majority of applications are processed, and certificates are mailed in less than 3 working days.
What are dates of examination and expiration?
Date of Examination
The Coast Guard considers the date of examination to be the date that it approves the issuance of a medical certificate. It will not coincide with the date the medical practitioner signed the CG-719K; nor will it necessarily coincide with the issuance date of the medical certificate or MMC.
Dates of Expiration
Expiration for national mariners: Medical certificates issued to national mariners will be issued for a maximum of 5 years.
What if I am receiving a medical waiver?
The Coast Guard may grant a waiver if an applicant for an MMC does not possess the vision, hearing or general physical condition necessary and extenuating circumstances warrant special consideration.
Here is a video on medical disqualifiers.
What can I do if my medical waiver gets denied?
In accordance with 46 CFR 1.03–40, you may request reconsideration of this decision. Your request for reconsideration should address any possible errors, provide new facts or information, and/or provide extenuating circumstances in order to mitigate the decision.
The request for reconsideration must be made in writing and postmarked no later than 30 days after the date of the denial letter.
The request for reconsideration will be reviewed and the applicant will be notified that the NMC has either:
- Reversed/modified the initial decision
- Upheld the decision to deny your application
If you disagree with the reconsideration decision, then you may make a formal appeal to the Director of Prevention Policy (CG-5P) at Coast Guard Headquarters within 30 days of the date of the reconsideration denial letter.
While a request for reconsideration is pending, the original decision or action remains in effect unless otherwise stayed. Failure to submit a formal request for reconsideration in accordance with the noted procedures and time limits will result in the decision or action becoming final agency action. It is recommended you retain copies of all material you send with any request for reconsideration. Attach a copy of the denial letter received to any documentation you provide to the NMC in response to the notification.
Requests for Reconsideration of Medical Denials:
A team of qualified physicians reviews all reconsideration requests to determine if your eligibility has changed. Reconsideration Approvals: Reconsideration approvals will be forwarded to the Professional Qualifications Evaluation (PQE) division for processing of your merchant mariner credential, if applicable.
A medical waiver may be included with your medical certificate (see Medical Waivers).
USCG practices, with respect to the physical and medical evaluation process, continually evolve to align with current medical standards of care and current safety standards. Although the current NVIC 04-08 details specific medical conditions and the recommended data for evaluation of these conditions, it is not all inclusive or definitive and may be subject to further review.