ML5 medical report form and certificate MSF 4112 rev0518

A report outlining your medical history and current health, enabling your doctor to decide on your fitness to work safely at sea.


ML5 Seafarer medical report form and certificate MSF 4112 rev0518

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Complete these forms and take them to your doctor to be filled in. It doesn’t have to be a Maritime and Coastguard Agency (MCA) approved doctor.

This form is for

  • anyone applying for, revalidating, or changing their MCA Boatmaster’s Licence or certificate
  • anyone applying for a Royal Yacht Association (RYA) commercial endorsement for working on code vessels (see the form for more detail)
  • crew on a seagoing or domestic passenger vessel
Published 15 May 2018