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MSF 4112 / REV0305 SEAFARER MEDICAL REPORT FORM (ML5) AND ML5 CERTIFICATE WHO MAY USE THIS FORM is for use in connection with an application for: a) a Boat master's License for use on a non-seagoing

How to fill out seafarer medical report form

1. The seafarer medical report form is typically required for individuals who are involved in the maritime industry, such as sailors, ship crew members, offshore workers, or anyone seeking employment on a vessel or rig.
2. To fill out the seafarer medical report form, gather all necessary personal information, such as your full name, date of birth, contact details, and passport number.
3. The form will also require you to disclose any previous medical conditions, surgeries, or hospitalizations. Be sure to provide accurate and detailed information about any pre-existing conditions you may have.
4. You may need to visit a certified medical practitioner or professional for a medical examination. The form will usually require you to provide information about your current health status, including a general assessment of your physical and mental well-being.
5. Some sections of the form may ask for specific medical tests or screenings to be conducted, such as blood tests, vision and hearing assessments, or drug and alcohol screenings. Make sure to complete all the required tests and provide the results, if applicable.
6. It is essential to answer all questions on the form honestly and accurately. This includes disclosing any current medications you are taking or any allergies you may have.
7. Review the completed form thoroughly to ensure all information is correct and legible. Double-check that all sections and questions are properly filled out.
8. Once you have completed the form, make sure to sign and date it as required. In some instances, the form may also require an authorized medical professional's signature or stamp.
9. Keep a copy of the filled-out form for your records and submit the original to the respective authority, employer, or organization that requested it.
10. Remember, the seafarer medical report form is crucial for ensuring the safety and well-being of individuals working in the maritime industry. Complying with the requirements and providing accurate information is essential.

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What is seafarer medical report form?

The seafarer medical report form is a document that records the medical fitness of a seafarer.

Who is required to file seafarer medical report form?

Seafarers are required to file the seafarer medical report form.

How to fill out seafarer medical report form?

The seafarer should visit a qualified medical practitioner to undergo a medical examination and complete the form with the results.

What is the purpose of seafarer medical report form?

The purpose of the seafarer medical report form is to ensure that seafarers are fit for duty and do not pose a risk to themselves or others on board.

What information must be reported on seafarer medical report form?

Information such as medical history, current medications, vital signs, and any medical conditions must be reported on the seafarer medical report form.