Certificate of medical fitness for domestic seafarers form 1850
This form lets us know that you are medically fit for working at sea.
When do I need a certificate of medical fitness?
You will need a certificate of medical fitness if you are applying for:
- any new or equivalent domestic certificate of competency
- any renewal of a high complexity domestic certificate of competency
- any renewal of a low complexity certificate and you have answered yes to any of the questions in the medical declaration in your Certificate of competency renewal application form 426.
How to complete this form
Download and print the Certificate of medical fitness for Domestic Seafarers 1850 (PDF 334.35 KB) and the Standards for the medical examination of domestic seafarers.
Take the form and the Standards with you to your qualified medical practitioner. You must provide them with a proof of identity which may include a:
- driver’s licence
- other photo ID.
Give the medical practitioner the Standards for the medical examination of domestic seafarers. They will need to:
- read the Standards
- check your identity
- examine you
- fill out the form
- sign it
- return the completed Certificate of medical fitness to you.
Submitting the form
Submit this form with your Certificate of competency application form 426.
Specific requirements for your certificate of competency can be found on the page for that certificate. Find your certificate of competency in Domestic certification.