CERTIFICATE OF MEDICAL FITNESS

This Certificate of medical fitness is to be used by an AMSA appointed Medical inspector in conjunction with the
following documents:
• Standards for the medical examination of seafarers and coastal pilots
• Medical examination report (AMSA 232)
Both of these documents can be found on the AMSA website: www.amsa.gov.au

The Standards Seeking guidance

Marine Order 76 (Health—medical fitness) 2017 requires Any questions regarding the content of the Standards,
that a Medical inspector have regard to the Standards for Medical examination report or Certificate of medical
the medical examination of seafarers and coastal pilots fitness should be directed to the Sonic HealthPlus
and the relevant job task analyses contained within. Seafarer administration team for referral to a senior
The assessment of medical fitness for service at sea occupational physician (if required):
is a matter for the Medical inspector’s professional Ph: 1300 277 904
judgement. The Standards are to assist a Medical Email: seafarermedicals@sonichealthplus.com.au
inspector in coming to a decision.
Part B of the Standards contains the medical standards Distribution of copies
including tests that are either desirable or essential to SHP Seafarer administration team:
carry out. The Standards also suggest areas where it
may be appropriate or mandatory to refer a person for Duplicate (green) of the Certificate of medical fitness
further testing. and a copy of the Medical examination report.

Departments Scan and email clear/legible copies to

seafarermedicals@sonichealthplus.com.au while
Deck: the applicant is in the clinic.
Includes any seafarer serving as a Coastal pilot,
Master, Chief mate, Mate, Watchkeeper deck SHP will advise within approximately 15 minutes via
email if the certificate can be issued to the seafarer,
Engineering: or if further information is required.
Includes any seafarer serving as an Engineer class 1,
Engineer class 2, Electro-technical officer, Engineer If no response has been provided after
watchkeeper approximately 15 minutes call SHP
on 1300 277 904.
Integrated rating:
Includes any seafarer serving as a Chief integrated Applicant:
rating, Integrated rating Original (blue) Certificate of medical fitness
Rating deck: must be given to Applicant, only after review and
Includes any seafarer serving as Able seafarer deck, confirmation by SHP. If requested, copy of Medical
Rating navigational watch examination report may also be given.

Rating engineering: Medical inspector:

Includes any seafarer serving as Able seafarer engine, Triplicate (white) Certificate of medical fitness and
Rating engine room watch the original of the Medical examination report to be
Catering: retained by the Medical inspector for a period of at
Includes any seafarer serving as a Hotel manager, least 30 years.
Chief steward, Steward, Marine cook, Caterer, Caterer Overseas applicants:
attendant, Purser, working in the hospitality or hotel Medical inspector to retain a copy of the Medical
section of a vessel examination report for a period of at least 30 years.
Other: Forward a certified copy of Medical examination
Includes any seafarer serving as a shop keeper, report (AMSA 232) and Certificate of medical fitness
Entertainer, etc, not included above. (AMSA 303) to:
Period of review/certificate expiry date Australian Maritime Safety Authority
The maximum period of review for a Certificate of Seafarer Certification Service
medical fitness is: Operations
GPO Box 2181
• Under 18/over 55–1 year Canberra
• 18 to 55–2 years. ACT 2601
If period of review is less than the above the Medical AUSTRALIA
inspector should state the reason on the certificate.
AMSA 303 (6/19)

AMSA CERTIFICATE OF MEDICAL FITNESS AMSA 303 (6/19)

 CERTIFICATE OF MEDICAL FITNESS
To be used in conjunction with Medical Examination Report (AMSA 232)

This certificate is issued in compliance with:

Date of examination Certificate expiry date (if unfit, enter date of
• the International Convention on Standards of Training, Certification examination)
and Watchkeeping for Seafarers 1978, as amended (STCW) DD / MM /20 YY DD / MM /20 YY
Regulation I/9,
• the Maritime Labour Convention, 2006 (MLC 2006) Regulation 1.2, Place of examination
• the Navigation Act 2012 and ACT NSW NT QLD SA TAS VIC WA
• Marine Order 76 (Health – medical fitness) 2017. country of examination
Overseas:

Applicant details (as recorded on proof of identity) Declaration of the Medical Inspector
I have evaluated the above-named applicant and on the basis of the applicant’s
Family name
personal declaration, my clinical examination and diagnostic test results
recorded on the Medical Examination Report,
I declare the applicant is:
Given name(s)
Fit – and is not suffering from a medical condition likely to be
aggravated by, or to render him/her unfit for service at sea or
likely to endanger the health of other persons on board.
Seafarer ID Fit* – with restrictions as detailed below.
Unfit* – details and action taken shown below.

Gender *Restrictions
M Male F Female X Indeterminate Duties:

Date of birth

DD / MM / YYYY
Nationality Location / vessel:

Permanent address
Medical / other:

Email
Must wear corrective lenses for distance vision
Must wear corrective lenses for near vision

Phone I can confirm the following (tick relevant boxes):

Eyesight:
Visual acuity meets standards Yes No - Unfit
Proof of identity (sighted by Medical Inspector) Applicant requires aids to vision Yes (Specify restrictions) No
Passport, or Number
Colour vision meets standards Yes No (Specify restrictions)
Australian driver licence
Date of last colour vision test DD / MM /20 YY
Department (tick relevant boxes) LLookout duties
Deck OfficerL - Deck Officer only:
Engineering OfficerH Fit for lookout duties Yes No - Unfit

Integrated RatingL,H - Integrated Rating, Rating-Deck only:

Fit for lookout duties Yes No (Specify restrictions)
Rating-DeckL
Hearing:
Rating-EngineeringH
Hearing meets standards Yes No - Unfit
CateringH
Unaided hearing satisfactory Yes No (Specify restrictions)
Other
Applicant used aids to hearing Yes (Specify restrictions) No
LDenotes lookout duties apply
HDenotes Hepatitis A arrangements apply HHep A (Engineering Officer, Integrated Rating, Rating-Engineering and Catering only):
Active immunity to Hepatitis A N/A Yes No (Specify restrictions)
I acknowledge that I have been advised of the content of the
Medical Examination Report and of my right to seek a review
of the content of this certificate. In the event of a change in my Medical Inspector of Seafarers
Official Stamp
medical status, I acknowledge the validity of this certificate should
be reviewed by a Medical Inspector. If I am regularly taking long Name of Medical
term medication, I will notify the vessel’s master. Inspector of Seafarers
(please stamp
Applicant’s signature Signature
all copies)

Distribution of copies: Original (Blue) – Applicant - only after review and confirmation by SHP; Duplicate (Green) – SHP Seafarer
Administration Team; Triplicate (White) – Medical Inspector of Seafarers (30 years) AMSA 303 (6/19)