Cruise Ship Crew Sign-On Medical Fitness Declaration

Pre-employment medical fitness declaration for incoming cruise ship crew at sign-on, covering current health status, medication disclosure, fitness for duty confirmation, and MLC medical certificate verification.

Declaration Overview

• Submission date
• Full name
• Crew ID / employee number
• Position / job title
• Vessel name
• Planned sign-on date

Medical Certificate Verification

• Do you currently hold a valid MLC medical certificate?
• MLC certificate issue date
• MLC certificate expiry date
• Issuing authority / clinic
• Upload a copy of your MLC medical certificate
  Upload only if requested by your crewing team or if your certificate details need verification.

Current Health Status

• Are you currently unwell or experiencing any symptoms that could affect safe work?
• Please describe the symptoms or condition
• Do you have any work restrictions, lifting limits, or duty limitations?
• Please describe your restrictions or limitations
• Have you received medical treatment, hospitalization, or emergency care in the last 30 days?
• Please provide brief details

Medication and Health Disclosure

• Are you currently taking any prescription medication that may affect alertness, mobility, or safe job performance?
• List the medication name and any relevant work impact
• Do you require secure storage or special handling for medication while onboard?
• Do you have any allergies or sensitivities that may require onboard awareness?
• Please briefly describe the allergy or sensitivity

Fitness for Duty Declaration

• I confirm that, to the best of my knowledge, I am fit for duty and able to safely perform the essential functions of my role.
• I confirm that I have disclosed any current condition, restriction, or medication that may affect my ability to work safely.
• I consent to the review of this declaration by authorized crewing, HR, and ship medical personnel for sign-on clearance purposes.
• Additional comments