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A report for your medical history and current health; lets your doctor decide on your fitness to work safely at sea.
Ref: REV 02/23
, ,
Download and print 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:
Updated ML5 medical report and certificate 13th February 2023.
Updated ML5 medical report form and certificate MSF 4112 February 2023.
Updated with a revision of the seafarer medical report (ML5) and ML5 certificate (MSF 4112) November 2021.
Most recent ML5 form added
Latest ML5 medical form added
September 2016 Revision Uploaded
First published.
Don’t include personal or financial information like your National Insurance number or credit card details.
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