Yes! You can use AI to fill out MSF 4104, Medical Examination of Seafarers Report (ENG2)
Don't type 176 fields by hand. Tell our AI about yourself, or upload your insurance card, and it fills every field in seconds. You check it, then download, print or sign.
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What this form asks for
The AI fills all of it, from your answers or your documents.
The AI checks your answers before you download
14 checks built for this form, so a wrong date or a missing answer is caught before anyone else sees it.
This check verifies that for every medical condition in the Seafarer Medical History section (rows 1-31) where the 'Yes' box is checked, the corresponding 'If ‘Yes’, amplify' text field is not empty. This is crucial for the Approved Doctor (AD) to understand the full context and severity of the condition to make an accurate fitness assessment. A failure would result in an incomplete medical history, potentially leading to the form being rejected and requiring the seafarer to provide the missing information.
This validation ensures that if the seafarer indicates this is not their first ENG1 examination by selecting 'No', then the fields for 'Previous fitness category', 'Name of previous AD', and 'Date of Examination' are all completed. This information is vital for continuity of care and understanding the seafarer's medical history over time. If these fields are empty, the form submission would be flagged as incomplete, preventing the AD from properly assessing changes in the seafarer's health status.
This check confirms that all date fields ('Date of examination by previous AD', 'Seafarer Signature Date', 'Date' of doctor's signature) are in a valid format (e.g., DD/MM/YYYY). It also cross-references these dates to ensure logical consistency, such as the previous examination date being before the current examination date. Incorrect or illogical dates can invalidate the legal standing of the document and cause significant processing delays.
This check automatically calculates the Body Mass Index (BMI) using the provided 'Height' (in meters) and 'Weight' (in kilos) and compares it to the value entered in the 'BMI' field. This ensures the accuracy of the BMI, which is a key indicator of health and fitness for duty. A discrepancy would trigger a warning, prompting the user to review and correct the height, weight, or BMI values to ensure the assessment is based on correct data.
This validation verifies that the numeric values entered for 'Height', 'Weight', 'Pulse rate', and 'Blood pressure' fall within a medically plausible range for an adult human. For example, it would flag a pulse rate of 300 or a weight of 1000 kg as likely errors. This check acts as a safeguard against data entry mistakes that could lead to a flawed medical assessment and incorrect fitness determination.
This validation ensures that for each item in the Physical Examination section (Teeth, ENT, Skin, etc.), if the 'Yes' box is ticked (indicating an abnormality), the corresponding details field is populated. This is critical for documenting the nature of the abnormality and any required follow-up. Failure to provide details for a noted abnormality would result in an incomplete report, requiring clarification from the examining doctor.
And 8 more checks
- Ensures Findings are Documented When Extra Tests are Required
- Confirms All Medical History Yes/No Questions are Answered
- Verifies All Physical Examination Yes/No Categories are Completed
- Validates Doctor's Name and Signature Date
- Requires Details for Positive Family Medical History
- Ensures Quantification of Tobacco and Alcohol Use
- Ensures Seafarer's Full Name is Provided
- Confirms Seafarer Signature Date is Present
Let AI fill out your MSF 4104 / ENG2
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How to Fill Out MSF 4104 / ENG2 Online for Free in 2026
What the AI walks you through.
- Navigate to Instafill.ai and upload or select the MSF 4104 / ENG2 form.
- The seafarer uses the AI assistant to accurately input their personal details, family medical history, and previous examination information in Sections 1 and 2.
- The seafarer completes the detailed medical history questionnaire in Section 3, answering all yes/no questions and providing amplified details for any conditions as prompted by the tool.
- The MCA-approved doctor (AD) inputs the physical examination findings from Section 4, including height, weight, blood pressure, and urine test results.
- The doctor completes the system-by-system physical examination checklist, noting any abnormalities and indicating if extra tests are required.
- The seafarer and the doctor digitally sign and date the form in the designated sections to certify the accuracy of the information provided and the examination results.
- Review all entered information for accuracy before finalizing and submitting the report through the ENG2 online system as required.
Common Mistakes in Completing MSF 4104 / ENG2
The ones the AI is built to catch.
Incomplete 'Yes' Answers
Vague Lifestyle Information
Omitting Past Medical Events
Forgetting Previous ENG1 Certificate Details
Misinterpreting 'Family Medical History'
Failing to Disclose All Medications
Incorrect or Incomplete Personal Names
Inconsistent Medical Information
Illegible Handwriting or Poor Formatting
Signing the Declaration Without Review
Using Ambiguous Medical Descriptions
Frequently Asked Questions About MSF 4104 / ENG2
Is it really free for 7 days?
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How complex is MSF 4104 / ENG2 to fill out?
What is the purpose of the MSF 4104 form?
Who needs to fill out this form?
What information do I need to provide for the medical history section?
What should I bring to my ENG1 medical examination?
What does 'amplify' mean on the medical history questionnaire?
What happens if this is not my first ENG1 medical examination?
Why is my signature required on the form?
What does the physical examination in Section 4 involve?
Can an AI tool help me prepare for filling out this form?
How can I fill out this form online before my appointment?
The PDF version of this form I found is not fillable. What can I do?
What is an 'AD' mentioned on the form?
What kind of family medical history do I need to report?
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Other forms like this one
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seafarer forms: Beneficiary Designation for Seafarers International Union AGLIW 401(k) Plan, Döhle Marine Services Europe Ltd Seafarer Application
VA medical forms: Form OWCP-915, Claim for Medical Reimbursement, Form 8994, Employer Credit for Paid Family and Medical Leave, Form OF-178, Certificate of Medical Examination, Form N-648, Medical Certification for Disability Exceptions, U.S. Coast Guard Form CG-719K, Application for Medical Certificate, The Department of Medical Assistance Services Applied Behavior Analysis Preservice Service Authorization Request Form (Effective Dates of Service 09/01/2025 and after), State of Illinois Department of Children and Family Services Medical Report on an Adult in a Child Care Facility (CFS 602), Carer Payment and Carer Allowance – Medical Report (SA431) for a child under 16 years, Medically Prescribed Treatment (Non-Medication) Form — Provider Treatment Order Form | Office of School Health | School Year 2025–2026, VA Form 10-7959f-2, Foreign Medical Program (FMP) Claim Cover Sheet, Department of Medical Assistance Services Applied Behavior Analysis (97155, Et al.) Initial Service Authorization Request Form, Applied Behavior Analysis Concurrent Service Authorization Request Form (CPT Codes 97153, 97154, 97155, 97156, 97157, 97158, 0373T) – Virginia Department of Medical Assistance Services, Department of Medical Assistance Services Enhanced Services Individual Service Plan (ISP) Template, Form DS-1843, Medical History and Examination for Individuals Age 12 and Older, Scheduled Medical Leave of Absence (MLOA) - BLET 13, Admissions Application, School of Diagnostic Imaging, Mills-Peninsula Medical Center, Albany Medical Center 2024 Benefits Guide, Form BWC-1141, Request for Medical Information, VA Form 21P-8416, Medical Expense Report, Medicare Enrollment Application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers, CMS-855S
Medi-Cal forms: Form OWCP-915, Claim for Medical Reimbursement, Form 8994, Employer Credit for Paid Family and Medical Leave, Form OF-178, Certificate of Medical Examination, Form N-648, Medical Certification for Disability Exceptions, U.S. Coast Guard Form CG-719K, Application for Medical Certificate, The Department of Medical Assistance Services Applied Behavior Analysis Preservice Service Authorization Request Form (Effective Dates of Service 09/01/2025 and after), State of Illinois Department of Children and Family Services Medical Report on an Adult in a Child Care Facility (CFS 602), Carer Payment and Carer Allowance – Medical Report (SA431) for a child under 16 years, Medically Prescribed Treatment (Non-Medication) Form — Provider Treatment Order Form | Office of School Health | School Year 2025–2026, VA Form 10-7959f-2, Foreign Medical Program (FMP) Claim Cover Sheet, ABA Authorization Request (Medi-Cal) – Initial and Concurrent Requests, Department of Medical Assistance Services Applied Behavior Analysis (97155, Et al.) Initial Service Authorization Request Form, Applied Behavior Analysis Concurrent Service Authorization Request Form (CPT Codes 97153, 97154, 97155, 97156, 97157, 97158, 0373T) – Virginia Department of Medical Assistance Services, Department of Medical Assistance Services Enhanced Services Individual Service Plan (ISP) Template, Form DS-1843, Medical History and Examination for Individuals Age 12 and Older, Scheduled Medical Leave of Absence (MLOA) - BLET 13, Admissions Application, School of Diagnostic Imaging, Mills-Peninsula Medical Center, Albany Medical Center 2024 Benefits Guide, Form BWC-1141, Request for Medical Information, VA Form 21P-8416, Medical Expense Report

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