USCG Mariner Federal Verified 2026-07-07mandatory

CG-719K/EApplication for Medical Certificate — Entry-Level Ratings

Issued by U.S. Coast Guard – National Maritime Center

CG-719K/E is the abbreviated medical evaluation report for mariners applying only for entry-level ratings (such as ordinary seaman, wiper, or steward’s department). It is shorter than the full CG-719K; any application including an officer or STCW endorsement requires the full CG-719K instead.

Also known as: CG-719K/E · 719KE · Entry-level mariner medical form · Short-form mariner physical

Official agency source Agency forms index

Key facts

Clinicians fill out · Employees complete · Submitted to regulator

When it’s used
Submitted with an MMC application limited to entry-level ratings. Not valid for original, renewal, or raise-of-grade applications that include officer endorsements, STCW endorsements, or first-class pilotage — those require the full CG-719K.
Who fills it out
Examining licensed medical practitioner completes the evaluation; the mariner completes the personal and medical-history sections.
Who signs
Licensed physician, physician assistant, or advanced practice registered nurse authorized under 46 CFR 10.304 to perform mariner medical evaluations.
Where it goes
Submit to the USCG National Maritime Center with the mariner's credential application (ASAP portal, email, or mail).
Electronic submission
Supported — accepted via the NMC ASAP portal and email.

Sources & citations

Every form we publish traces to an authoritative government source. We cite the issuing agency, the underlying statute, and the operative regulation so you can verify scope and signing authority for your own records.

  • Issuing agency

    USCG National Maritime Center — Forms

    Last verified 2026-07-07

    VerifiedOpen

  • Regulation

    46 CFR Part 10, Subpart C — Medical and Physical Standards

    Last verified 2026-07-07

    VerifiedOpen

Attribution. Form authored and maintained by the U.S. Coast Guard National Maritime Center. BlueHive does not modify the underlying government PDF; the file you download is the agency original.

Related forms

These forms are commonly filed alongside or in place of this one.

Need a provider who can complete this form?

BlueHive’s coordination network handles the services this form ties into. Each service page lists the providers in our network who routinely complete it.

Going to this appointment? Here’s what to bring

Share an employee preparation guide so the visit goes smoothly. Each guide covers what to bring, how to prepare, and what to expect — bilingual EN/ES.

Important Legal Notice

The regulatory information presented on BlueHive Compliance Watch is provided for general informational purposes only and should not be construed as legal advice. While we strive to maintain accurate and up-to-date information, regulations can change rapidly and may be subject to interpretation.

You should always:

  • Consult with qualified legal counsel before making compliance decisions
  • Verify information with official government sources
  • Review the full text of any regulation cited herein
  • Consider jurisdiction-specific requirements that may apply to your organization

BlueHive Health, LLC makes no warranties or representations about the accuracy, completeness, or timeliness of this information. We are not responsible for any actions taken or not taken based on this content.

OSHA Official Website • U.S. Department of Labor • FMCSA

Need help completing this form?

BlueHive coordinates the visit, captures the signed form, and routes it to the right destination — across DOT, USCG, workers' comp, and more.