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AMSA 559

Certificate of medical fitness for a near coastal certificate

Overview 

This form lets us know that you are medically fit for working at sea. 

AMSA form 559 is used for domestic or near coastal qualification applications. For international marine qualifications use AMSA form 303.

When do I need a certificate of medical fitness?

You will need a certificate of medical fitness if you are applying for:

 

How to complete this form 

Download and print the Certificate of medical fitness for a near coastal certificate form 559 and the Guidelines for the medical assessment of near coastal seafarers.

Section A of the form is for you to complete your details.

Sections B, D and E must be completed by a qualified medical practitioner.

Fill out your details in section A and take the form and the guidelines with you to your qualified medical practitioner. You must provide them with a proof of identity which may include a:

  • passport
  • driver’s licence
  • other photo ID.

Give the medical practitioner the Guidelines for the medical assessment of near coastal seafarers. They will need to:

  • read the guidelines
  • check your identity
  • examine you
  • fill out the remaining information on the form
  • sign it
  • return the completed Certificate of medical fitness to you.

Submitting the form 

Additional information 

Specific requirements for your certificate of competency can be found on the page for that certificate. Find your certificate of competency in Domestic certification.

Last Updated: 

2 December 2019