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DOT FORM

PLEASE COMPLETE SECTION 1 ONLY (SAVE FILE & EMAIL TO dotandphysicalexaminer@medicalstop.org)

Medical Examination Report Form MCSA-5875 23 (pdf)

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MERCHANT MARINE SEAMEN FORMS

PLEASE COMPLETE SECTION 1 ONLY OF MEDICAL FORM (SAVE FILE & EMAIL TO dotandphysicalexaminer@medicalstop.org)

Medical Form (Full) (pdf)

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Drug Test Form (pdf)

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School Entry Health Exam & Consent Form

PLEASE COMPLETE HIGHLIGHTED AREAS ONLY AND EMAIL TO dotandphysicalexaminer@medicalstop.org

School-Health-Entry-Exam-form-dh3040-chp-07-2013 (1) (pdf)

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Child Medical Consent Form. (pdf)

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Physical Evaluation & Consent Forms.

 PLEASE PRINT AND COMPLETE PAGES 1 & 2 ONLY (BEFORE YOUR APPOINTMENT). BRING FORMS WITH YOU TO APPOINTMENT. 

Physical Form *PRINTABLE ONLY* (pdf)

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Child Medical Consent form for physical. (pdf)

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Online completion forms for Medical Weight loss.

Semaglutide/ Tirzepatide, B12 Lipo,  L-Carnitine (MS. SKINNY SHOT) Intake and Consent forms.

**SAVE COMPLETED FORMS & EMAIL TO dotandphysicalexaminer@medicalstop.org


B12 LIPO, L-CARNITINE (MS. SKINNY SHOT) CONSENT FORMS ONLY *ONLINE COMPLETION. (pdf)

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B12/ B12 LIPO/ L-CARNITINE (MS. SKINNY SHOT) INTAKE & CONSENT FORMS. *ONLINE COMPLETION. (pdf)

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SEMAGLUTIDE /TIRZEPATIDE CONSENT FORMS ONLY **ONLINE COMPLETION* (pdf)

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SEMAGLUTIDE / TIRZEPATIDE INTAKE AND CONSENT FORMS. **ONLINE USE ONLY (pdf)

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