SHC Forms

Forms/Immunizations required upon Admission, Due: May 3rd, 2022

• ONLINE HEALTH INSURANCE WAIVER - NOW OPEN FOR ACADEMIC YEAR 22/23

  JCB Insurance Solutions Student Customer Service Line (707) 692-3043

• Minimum Insurance Requirements to Waive

• Cal Maritime Health Report for Marine Transportation, Mechanical Engineering-USCG License, and Marine Engineering Technology

• Cal Maritime Health Report for Business, Global Studies, Mechanical Engineering-General, Facilities Engineering Technology, and Oceanography

  • For more information regarding USCG Medical, Psychological & Physical Guidelines please view the NMC Merchant Mariner Medical Manual 08/2019.

• Hepatitis B Immunization Requirements 

• Meningococcal Disease and Immunization 

• Two MMR/MMRV (Measles, Mumps, Rubella & Varicella), Polio vaccination history, TD/Tdap history & current vaccine within the last 10 years & TB (Tuberculin) Skin test within the last 1 year.

• Abridgement of Drug Testing Form

• Athletic Physical Forms (Pages 2 & 4 of Health Report)

Readmission Form

• Readmission Health Statement

Employee Cruise Physical Forms

• Pre-Cruise Physical Memo

• Employee Cruise Physical

U.S. Coast Guard Physical Forms

• Merchant Mariner's Physical Exam Report (CG-719K)

Miscellaneous Forms

• Abridgement of Drug Testing Form

• Consent for Medical Release