Merchant mariners need a Coast Guard medical certificate under 46 CFR Part 10, and this 10-page application is how the National Maritime Center evaluates them. The practitioner reviews the mariner's reported conditions and medications, performs the 17-item physical exam, records vision, color vision, hearing and physical ability, and recommends certification; the Coast Guard keeps final authority.
The mariner completes Sections I, III(a), IV and X. A physician, PA or NP licensed by a U.S. state, possession or territory completes Sections II, III(b) and V to IX and initials each page; U.S. registered pilots must be examined by a licensed medical doctor.
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Application for Medical Certificate
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No. A physician, physician assistant or nurse practitioner licensed by any U.S. state, possession or territory can perform, witness or review the exams. The exception is U.S. registered pilots, whose exam must be conducted by a licensed medical doctor. Coast Guard guidance for providers is in the Merchant Mariner Medical Manual, COMDTINST M16721.48.
For every condition the mariner reports, the name, approximate date of diagnosis, treatment, current status and limitations. For conditions previously reported to the Coast Guard, only the interval history and current status. Recommended supporting documentation and testing for conditions subject to further review are in the Merchant Mariner Medical Manual.
CG-719K is the full 10-page exam with medical history, medications, a 17-item physical, vision and hearing. CG-719K/E is a 5-page short form for mariners holding only entry-level or staff officer endorsements, such as food handlers or those without watch or lookout duties. All other mariners need the full CG-719K.