Form CG-719K: Application for Medical Certificate

How to Prepare for Your CG-719K Medical Exam

Click below to download the medical physical form 👇 

Application for Medical Certification (CG-719K)

What is Form CG-719K used for?

The medical certificate confirms that a mariner meets the medical and physical standards required to perform their duties safely. It is issued by the Coast Guard as part of the Merchant Mariner Credential (MMC) process and aligns with regulations in the Federal Register (FR).

The National Maritime Center uses Form CG-719K to verify that mariners can meet the physical requirements necessary for effective communication, including having adequate hearing and speech to detect audible alarms. It also ensures that mariners do not have medical conditions, disorders, or impairments that could prevent the safe performance of routine or emergency duties. Additionally, the form confirms that mariners are fit for service at sea, with no medical conditions that may worsen during service or endanger others, and that they are not taking medications that impair judgment, balance, or the ability to perform duties safely.

To qualify for a medical certificate, a mariner must provide evidence of meeting the medical and physical standards through the completion of Form CG-719K.

How do I complete this form?

To complete the form, use an Adobe PDF application. Alternatively, you can print the form, manually fill it out, scan it back into a PDF format, and save the file with the appropriate name. 

Once completed, save the document to your desktop using the following file name format: LAST NAME_FIRST NAME_MARINER REFERENCE NUMBER (Note: Original applicants will not have a Mariner Reference Number yet). 

📽️ Check out the National Maritime Center's video, released on 7/25/24, that goes in-depth on CG-719K.

Where do I go about getting my physical?

You can go to a doctor’s office to get your physical done. A physician, physician assistant, or nurse practitioner who is licensed in the U.S. or a U.S. territory can fill out and record their findings on form CG-719K. You can also try walk-in clinics or places that do employment physicals.  

What do I select under Section I:  Endorsement Held or Sought?  

On CG-719K, Section I: Applicant Information, Under Endorsement Held or Sought, you will want to check off "Deck," because a captain's license is classified as a deck license. Do not select "Other".  

👀 Check out this document on common errors mariners make when submitting CG-719K. 

How long do I have to get this form completed when applying for the Coast Guard?  

The examination and CG-719K must be completed within 12 months of application date. 

Make sure your examination is timely to avoid delays in processing your application.

What is the cost of the medical certificate?

There is no cost for a medical certificate. Normal fees still apply to MMC transactions consistent with 46 CFR Table 10.219(a). A medical certificate will not negate nor increase the normal MMC fees. 

How long will it take for me to receive my medical certificate from the NMC?

Processing times will vary depending on the medical condition(s) reported and supplemental information provided. If your application is not filled out properly or if the National Maritime Center requires additional information to complete your evaluation, the processing will be delayed. On average, the majority of applications are processed, and certificates are mailed in less than 3 working days. 

What are dates of examination and expiration?

Date of Examination 

The Coast Guard considers the date of examination to be the date that it approves the issuance of a medical certificate. It will not coincide with the date the medical practitioner signed the CG-719K; nor will it necessarily coincide with the issuance date of the medical certificate or MMC. 

Dates of Expiration 

Expiration for national mariners: Medical certificates issued to national mariners will be issued for a maximum of 5 years. 

What if I am receiving a medical waiver?  

The Coast Guard may grant a waiver if an applicant for an MMC does not possess the vision, hearing or general physical condition necessary and extenuating circumstances warrant special consideration. 

📽️ Here is a video on medical disqualifiers.  

What can I do if my medical waiver gets denied?  

In accordance with 46 CFR 1.03–40, you may request reconsideration of this decision. Your request for reconsideration should address any possible errors, provide new facts or information, and/or provide extenuating circumstances in order to mitigate the decision.  

The request for reconsideration must be made in writing and postmarked no later than 30 days after the date of the denial letter.  

The request for reconsideration will be reviewed and the applicant will be notified that the NMC has either:  

1. Reversed/modified the initial decision 
2. Upheld the decision to deny your application 

If you disagree with the reconsideration decision, then you may make a formal appeal to the Director of Prevention Policy (CG-5P) at Coast Guard Headquarters within 30 days of the date of the reconsideration denial letter.  

While a request for reconsideration is pending, the original decision or action remains in effect unless otherwise stayed. Failure to submit a formal request for reconsideration in accordance with the noted procedures and time limits will result in the decision or action becoming final agency action. It is recommended you retain copies of all material you send with any request for reconsideration. Attach a copy of the denial letter received to any documentation you provide to the NMC in response to the notification.  

Requests for Reconsideration of Medical Denials:  

A team of qualified physicians reviews all reconsideration requests to determine if your eligibility has changed. Reconsideration Approvals: Reconsideration approvals will be forwarded to the Professional Qualifications Evaluation (PQE) division for processing of your merchant mariner credential, if applicable.

A medical waiver may be included with your medical certificate (see Medical Waivers). 

What do I do with the medical certificate when I receive it?