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U.S. DEPARTMENT OF HOMELAND SECURITY U.S. COAST GUARD CG-719K Rev. (01-09) Merchant Mariner Credential Medical Evaluation Report OMB-1625-0040 Expires 6/30/2012 Detailed guidance on the medical and
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How to fill out a medical evaluation is not?

01
Start by carefully reading the instructions provided with the medical evaluation form. Make sure you understand all the questions and sections involved.
02
Gather all relevant medical information that is required for the evaluation. This may include any past medical records, test results, and medications you are currently taking.
03
Begin filling out the form by providing your personal information, such as your name, date of birth, and contact details. Ensure that all information is accurate and up-to-date.
04
Move on to the sections related to your medical history. Answer all the questions honestly and to the best of your knowledge. Include any relevant details about past illnesses, surgeries, or conditions you have experienced.
05
If there are specific sections related to certain medical conditions or symptoms, document your experiences in a clear and concise manner. Use additional space if required to explain any details that may be important for evaluation purposes.
06
Fill out the sections related to current medications you are taking. Include the name of the medication, the dosage, and the reason for taking it. If you are unsure about any details, consult with your healthcare provider.
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Finally, review the completed form to ensure all sections have been addressed and all necessary information has been provided. Double-check for any errors or omissions. If needed, seek assistance from a healthcare professional to ensure accuracy.

Who needs a medical evaluation is not?

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Individuals seeking employment in certain professions may require a medical evaluation before being hired. This can include jobs that involve physical labor or potentially hazardous environments.
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Athletes who participate in competitive sports may need to undergo a medical evaluation to ensure they are physically fit to engage in their chosen activity.
03
Individuals who are applying for certain insurance policies, such as life insurance or disability insurance, may be required to undergo a medical evaluation to assess their overall health and determine premium rates.
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Some academic or educational programs, especially those in the healthcare field, may require students to undergo a medical evaluation to ensure they are physically capable of fulfilling the program's requirements.
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Individuals involved in legal cases, such as personal injury claims, may need a medical evaluation to document and assess any injuries or related conditions.
It is important to note that the specific requirements for a medical evaluation may vary depending on the purpose and context in which it is needed. It is always advisable to consult with the relevant authority or healthcare professional to determine the exact requirements for a medical evaluation in a given situation.
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Medical evaluation is not a diagnosis or treatment plan. It is an assessment of an individual's medical condition.
Any individual seeking a medical evaluation is required to file it.
Medical evaluations can be filled out by a licensed healthcare provider or by the individual themselves.
The purpose of a medical evaluation is to provide information about an individual's medical condition.
Information such as medical history, current medications, and any relevant medical tests must be reported on a medical evaluation.
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