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STCW ELECTROMECHANICAL RATING 750kW/1,000 HP OR MORE 12.611 NAME: REFERENCE #: General Requirements Verify: U.S. Citizenship Age 18 Verify MILD set to Y for SSE Screening Verify Medical Certificate

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How to fill out cg-719c - united states

01

Step 1: Download the CG-719C form from the official website of the United States Coast Guard.

02

Step 2: Carefully read the instructions provided with the form to understand the requirements and guidelines for filling it out.

03

Step 3: Begin filling out the personal information section, including your name, address, date of birth, and contact details.

04

Step 4: Provide details about your physical condition and health history, including any medical conditions or medications you are currently taking.

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Step 5: Complete the certification section, where you will attest to the accuracy and truthfulness of the information provided.

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Step 6: Review the filled-out form to ensure all information is accurate and complete.

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Step 7: Sign and date the form.

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Step 8: Make a copy of the filled-out form for your records.

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Step 9: Submit the original form to the appropriate authority as specified in the instructions.

Who needs cg-719c - united states?

01

The CG-719C form is required for individuals who are applying for or renewing their Merchant Mariner Credential (MMC) from the United States Coast Guard.

02

It is also needed by individuals seeking to work on certain vessels or engage in specific maritime activities, as determined by the Coast Guard's regulations.

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What is cg-719c - united states?

CG-719C is the Merchant Mariner Credential Medical Evaluation Report form used in the United States.

Who is required to file cg-719c - united states?

Mariners applying for or renewing a Merchant Mariner Credential in the United States are required to file CG-719C.

How to fill out cg-719c - united states?

CG-719C form can be filled out by the applicant's healthcare provider or a certified medical professional.

What is the purpose of cg-719c - united states?

The purpose of CG-719C is to assess the medical fitness of mariners to ensure they meet the physical standards required for their duties at sea.

What information must be reported on cg-719c - united states?

CG-719C requires information about the applicant's medical history, current medications, physical examination results, and any potential contraindications for maritime work.

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