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USCG CG-719K 2024-2025 free printable template

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DEPARTMENT OF HOMELAND SECURITYOMB No. 16250040U.S. Coast GuardExp. Date: 04/30/2026APPLICATION FOR MEDICAL CERTIFICATE (FORM CG719K) Privacy Act Statement Pursuant to 5 U.S.C. 552a(e)(3), this Privacy
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6. Can I use my MMC as a Passport? No. While the MMC is a government-issued document, when traveling abroad you are still required to possess a valid U.S. Passport.
This means the certificate is really only good for 18 months. For those of you required by your company to get an annual physical, make sure the medical provider fills out the Coast Guard medical form (CG-719K), and make sure to submit it annually.
The CG-719 K/E form should be used only by mariners seeking an entry level merchant mariner credential. This form is limited to applicants for the following rating endorsements: Ordinary Seaman, Wiper, or Steward's Department (food handler). The CG-719K form should be used for all other endorsement applications.
This means the certificate is really only good for 18 months. For those of you required by your company to get an annual physical, make sure the medical provider fills out the Coast Guard medical form (CG-719K), and make sure to submit it annually.
APPLICATION FOR MEDICAL CERTIFICATE (FORM CG-719K)
The preferred method to submit your application and supporting documentation is via e-mail to MEDAIP@uscg.mil. Please include your full name in the subject line and ensure attachments are in PDF format. A CG-719B can ONLY be submitted to a Regional Exam Center.
The CG-719K and CG-719K/E serve as applications for a medical certificate. In order to renew the medical certificate prior to expiration, mariners must submit an application. Applications can be submitted through a Regional Exam Center (REC) or directly to the NMC.
NPT is the total time the Coast Guard spends processing the application and does not include the time waiting for information from mariners. The NMC has set a NPT goal of 20 days.
An MMC is valid for a term of 5 years. Adding an endorsement during this period does not change the expiration date. The only time the expiration date will change is when a mariner applies for and meets all renewal requirements. Once an MMC has expired, a mariner may not serve under the authority of that credential.
Steps to Apply for an Original MMC Determine the Officer and/or Ratings that you wish to obtain by visiting the NMC's Checklist Page. Obtain a Transportation Worker's Identification Credential. Fill out a CG-719B Application for Merchant Mariner Credential. (IF APPLICABLE) Fill out a CG-719C Conviction Statement.
NPT is the total time the Coast Guard spends processing the application and does not include the time waiting for information from mariners. The NMC has set a NPT goal of 20 days.
For a medical certificate only, the preferred way to submit your CG-719K or CG-719K/E (medical certificate applications) along with any supplemental medical information is via e-mail to MEDAIP@uscg.mil. Please include your full name in the subject line.

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