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MSF 4104, Medical Examination of Seafarers Report (ENG2), page 1
Complex · 74/100Form Complexity Index

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What this form asks for

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Form MSF 4104, also known as the ENG2 report, is a detailed medical examination record for seafarers, mandated by the UK's Maritime and Coastguard Agency (MCA). It is a critical document used by approved medical practitioners to assess and report on a seafarer's physical and mental fitness, ensuring they meet the required health standards for life at sea. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
Fillable fields176
Pages2
Sections60
Tables and lists2
Questions that depend on earlier answers50
Form Complexity IndexComplex, 74/100

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.

Ensures Amplification for 'Yes' Answers in Medical History

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.

Validates Previous Examination Details for Non-First-Time ENG1

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.

Verifies Date Format and Chronological Consistency

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.

Validates BMI Calculation Against Height and Weight

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.

Checks for Realistic Physical Examination Values

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.

Requires Details for Abnormal Physical Examination Findings

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

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How to Fill Out MSF 4104 / ENG2 Online for Free in 2026

What the AI walks you through.

  1. Navigate to Instafill.ai and upload or select the MSF 4104 / ENG2 form.
  2. The seafarer uses the AI assistant to accurately input their personal details, family medical history, and previous examination information in Sections 1 and 2.
  3. 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.
  4. The MCA-approved doctor (AD) inputs the physical examination findings from Section 4, including height, weight, blood pressure, and urine test results.
  5. The doctor completes the system-by-system physical examination checklist, noting any abnormalities and indicating if extra tests are required.
  6. 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.
  7. 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
A frequent error is checking 'Yes' for a medical condition in the history checklist but failing to provide the required details in the 'If 'Yes', amplify' column. This often happens when applicants rush or assume the checkbox alone is sufficient. This omission makes the form incomplete, forcing the doctor to halt the examination to request the missing information, which can cause significant delays in issuing the medical certificate.
Vague Lifestyle Information
Applicants often provide unhelpful, non-specific answers for tobacco and alcohol use, such as 'socially' or 'occasionally', when the form explicitly asks to 'quantify' intake. This ambiguity prevents the doctor from accurately assessing health risks, leading to further questioning and potential delays. To avoid this, calculate and provide specific figures, such as cigarettes smoked per day or alcohol units consumed per week.
Omitting Past Medical Events
Seafarers may fail to declare past surgeries, hospitalizations, or significant injuries, believing they are no longer relevant if they have recovered. This is a serious error, as the signed declaration certifies the form is a true statement, and non-disclosure can invalidate the certificate if discovered later. It is crucial to disclose all major past events and let the doctor determine their relevance for a valid and safe assessment.
Forgetting Previous ENG1 Certificate Details
When renewing a certificate, applicants often forget key details from their previous ENG1, such as the doctor's name, date of examination, or the reason for a prior restriction. This happens due to poor personal record-keeping. The absence of this information prevents the new doctor from reviewing the seafarer's medical history progression, potentially leading to delays while records are tracked down.
Misinterpreting 'Family Medical History'
Applicants may list non-hereditary conditions or provide insufficient detail, such as writing 'heart disease' without specifying the relative or their age at diagnosis. This section is intended to identify genetic predispositions, and vague information prevents a proper risk assessment. To be effective, provide details on major hereditary conditions (e.g., diabetes, stroke) in immediate family members (parents, siblings), including the condition and age of onset.
Failing to Disclose All Medications
A common mistake is listing only prescription drugs while omitting regularly used over-the-counter (OTC) medications, vitamins, or herbal supplements. People often don't consider these as 'real' medicine, but they can have side effects or interact with other drugs. This omission can compromise the medical assessment; therefore, a complete list of all substances taken regularly must be provided.
Incorrect or Incomplete Personal Names
Using a nickname or failing to include all middle names as they appear on official identification is a critical error. The name on the medical certificate must exactly match the seafarer's passport and other official documents. Any discrepancy can lead to serious issues with employers, immigration, and port authorities, potentially delaying or preventing boarding.
Inconsistent Medical Information
Applicants sometimes provide contradictory information, such as denying a heart condition but listing heart medication in the 'Regular medication' section. This occurs due to carelessness or forgetting the link between a medication and its corresponding diagnosis. Such inconsistencies raise red flags for the doctor, eroding trust and requiring a lengthy clarification process that delays certification.
Illegible Handwriting or Poor Formatting
When filling out a printed PDF, illegible handwriting, or writing outside the designated fields can make the information unusable. This is equivalent to leaving a field blank and forces the medical staff to guess or request a new form, causing delays and potential data entry errors. Using a tool like Instafill.ai can convert a non-fillable PDF into a typed, cleanly formatted document, eliminating these issues.
Signing the Declaration Without Review
Many applicants sign the certification statement as a mere formality without thoroughly reviewing their answers. The signature is a legally binding confirmation that all information is true and complete. An undiscovered error or omission can lead to the invalidation of the certificate and serious professional or legal consequences for making a false declaration.
Using Ambiguous Medical Descriptions
In the detail fields, applicants may use slang or overly vague terms like 'bad back' or 'a touch of sugar' instead of the proper medical diagnosis. This happens when they don't know the correct term or try to downplay a condition's severity. This ambiguity prevents the doctor from accurately assessing the condition, potentially leading to an incorrect fitness decision or requiring a time-consuming re-interview to clarify the history.

Frequently Asked Questions About MSF 4104 / ENG2

 

Is it really free for 7 days?
Yes. You pay $0 today. Cancel before Nov 14 and you are never charged. Keep it, and it is $19.99 a month for 5 fills of your MSF 4104 / ENG2.
Can I fill other forms too?
This plan is for your MSF 4104 / ENG2: your own AI agent fills it as often as 5 times a month. To fill other forms and upload your own, choose a Professional plan from your account.
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From your account, in two clicks, any time. No email, no call.
How does the AI fill out MSF 4104 / ENG2?
You answer a few questions in plain words, or upload your insurance card. The AI reads what you give it and puts each answer into the right field of MSF 4104 / ENG2, on every page, in seconds. It checks the answers against the form's own rules, and you review and change anything before you download, print or sign.
What happens to my information?
It is encrypted in transit and at rest, and it is never used to train AI.
How complex is MSF 4104 / ENG2 to fill out?
MSF 4104 / ENG2 has a Form Complexity Index of 74 out of 100, in the complex tier: 176 fillable fields across 2 pages. Instafill.ai's AI fills it in under a minute, with every field there for you to review before you download.
What is the purpose of the MSF 4104 form?
The MSF 4104 form is the official Report of Medical Examination for Seafarers, used by a Maritime and Coastguard Agency (MCA) approved doctor to record the results of your ENG1 medical exam. It is used to determine your medical fitness to work at sea.
Who needs to fill out this form?
The seafarer is responsible for completing the personal details and medical history in Section 3. The MCA-approved doctor (AD) or a delegated health professional completes the physical examination findings in Section 4.
What information do I need to provide for the medical history section?
You must provide truthful information about your personal and family medical history, including any past or present illnesses, injuries, surgeries, allergies, and regular medications. You also need to quantify any tobacco and alcohol use.
What should I bring to my ENG1 medical examination?
You must bring a valid photo ID, such as a passport or discharge book. If this is not your first ENG1, you should also bring your previous medical certificate.
What does 'amplify' mean on the medical history questionnaire?
If you tick 'Yes' for any condition, 'amplify' means you must provide more specific details in the adjacent box. This includes the nature of the condition, dates, treatment, and current status.
What happens if this is not my first ENG1 medical examination?
You must declare that you have had a previous ENG1 exam and provide details such as your previous fitness category, the name of the previous doctor, and the date of that examination.
Why is my signature required on the form?
By signing the form, you certify that the medical history you have provided is a true and complete statement. Providing false information can invalidate any medical certificate issued based on the examination.
What does the physical examination in Section 4 involve?
The physical examination, performed only by the Approved Doctor, includes measuring your height, weight, pulse, and blood pressure, as well as conducting a urine test. The doctor will also systematically check your body systems like heart, lungs, and vision.
Can an AI tool help me prepare for filling out this form?
Yes, services like Instafill.ai use AI to help you accurately auto-fill your personal details and medical history. This can save time and help ensure the information you provide to the doctor is accurate and complete.
How can I fill out this form online before my appointment?
You can use a platform like Instafill.ai to upload and fill out the seafarer-completed sections of the form electronically. This allows you to type your information neatly before printing it for your appointment with the doctor.
The PDF version of this form I found is not fillable. What can I do?
If you have a non-fillable PDF, you can use Instafill.ai to convert it into an interactive, fillable form. This makes it easy to enter your information digitally before your examination.
What is an 'AD' mentioned on the form?
AD stands for 'Approved Doctor'. This is a medical practitioner who has been officially approved by the MCA to conduct seafarer medical examinations.
What kind of family medical history do I need to report?
You should report any significant hereditary conditions in your close family, such as diabetes, stroke, or heart disease. This information helps the doctor assess any potential genetic risks to your health.
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