Required Medical Documents

Thank you for completing the following health forms! Once you have read through and filled in each form, please submit them to the Health Services Office by email.

Failure to successfully submit the required records may result in your inability to register at MMA, participate in Orientation, or select certain majors.

Only Maine Maritime Academy forms will be accepted. The U.S. Department of Homeland Security Merchant Mariner Credential Medical Evaluation Report is Maine Maritime Academy’s official physical examination and medical information form, regardless of major. Please make copies of your forms for your records before you return the originals to Health Services.

If you have any questions, please do not hesitate to contact the Health Services Department directly. We are happy to assist you!

Tammy Tyler, RN, ASN
Director of Student Health Services
Phone: 207-326-2295
Fax: 207-326-2129
Email: tammy.tyler@mma.edu or healthservices@mma.edu

Required Forms & Notices

• Emergency Treatment of a Minor Permission Form (1 pg)
• Immunization Form (1 pg)
• Medical Evaluation & Physical Examination Forms
• Personal Information Form (2 pgs)
• Privacy Practices Notice (1 pg)