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USCG CG-719P: Periodic Drug Testing Form for Mariners

Merchant mariners applying for most credential transactions must show a passed DOT drug test under 46 CFR 16.220, and this optional two-page form documents one taken within the past 185 days. The mariner signs the specimen consent, and a Medical Review Officer records the SAMHSA-accredited laboratory, the drugs tested and the verified result.

Who completes it

The mariner completes and signs Section I. The Medical Review Officer, qualified under 49 CFR 40.121, names the laboratory in Section II and completes Section III with the verified result, qualifying organization and registration number, then signs.

Submitting and payment

How to submit it
The MRO returns the form to the mariner, who submits it with the credential application to the National Maritime Center; original results are required, and a fax is accepted only if sent directly from the MRO's or service agent's office.
Who pays
The form states that the cost of the drug test is the applicant's sole responsibility, not the Coast Guard's.

Good to know

  • A drug test is needed for all transactions except endorsements, documents of continuity, duplicates and STCW certificates, and only a 49 CFR Part 40 chemical test is accepted.
  • The specimen is analyzed for marijuana and cocaine metabolites, amphetamines, opiate metabolites and PCP, and must go to a SAMHSA-accredited laboratory or the test is invalid.
  • An MRO signature stamp is allowed for negative results only. Positive, adulterated, substituted or cancelled results are reported to the nearest Coast Guard Sector or Unit.
  • An employer letter can replace the form: proof of a random testing program for at least 60 of the previous 185 days, or a passed pre-employment test within 185 days.

Get the official form

Download the current version from the source each time; forms change without notice.

DOT/USCG Periodic Drug Testing Form

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

How recent must the drug test be for CG-719P?

The DOT chemical test must have been conducted within the past 185 days by a SAMHSA-accredited laboratory, and a Medical Review Officer must verify and sign the result. Collection can happen at an independent medical facility, a private physician's office or an employer site, as long as the collector meets 49 CFR Part 40 Subpart C.

Can an MRO use a signature stamp on CG-719P?

Only for negative results. The form allows the MRO's signature stamp when the verified result is negative. Positive results, refusals because of adulteration or substitution, and cancelled tests need the MRO's details in the result block and are reported to the nearest Coast Guard Sector or Unit.

Is CG-719P the only way to prove drug testing to the Coast Guard?

No. The form is optional. An original dated letter from the mariner's employer can show participation in a random testing program meeting 46 CFR 16.230 for at least 60 of the previous 185 days, or a passed pre-employment chemical test within the past 185 days.