Wharf 7, Pyrmont,
Sydney, NSW 2009
Telephone: (02) 9298 3888
Dear Doctor,
HEALTH ASSESSMENT FOR PASSENGER OF THE James Craig
Your patient has applied to become a passenger and possible assist crew of the square-rigged
sailing ship lames Craig. To ensure he/she is capable of taking part in the voyage in a safe
manner we require a medical assessment of his/her health. To help you make this assessment,
we have set out below some information as to what will be required of your patient as a crew
member.
Passengers in the James Craig may wish to participate in all aspects of sailing a tall ship. These
include:
* Climbing aloft and working some 30metres above the deck. This requires enough
upper-body strength to support own weight, and co-ordination of limbs to climb and
to haul on ropes, both on deck and aloft.
* Watch duties necessitate working for extended periods, resulting in limited and
broken sleep.
* Living and working with people in confined and often arduous conditions.
* Learning new skills and routines to ensure personal and shipboard safety.
It should be noted that the ship may be at sea for many days with the only access to medical
help via radio. The ship carries first aiders and although a doctor may sometimes be on board,
this cannot be guaranteed.
There are four conditions that absolutely preclude applicants:
1: Insulin-dependent Diabetes Mellitus
2: Epilepsy
3: Severe asthma
4: Pregnancy
Please advise your patient of any complications that a particular condition may have in the sea
environment described above. We enclose a form that may help you assess your patient, but
would ask you to retain this form for your records.
Please complete and sign the tear-off slip and give that to your patient to return to us. If you
feel your patient may be fit for limited duties, eg. not being at sea for longer than one day,
please add a note to that effect.
Thank you.
26/9/14
Sydney Maritime Museum Limited trading as Sydney Heritage Fleet ABN 70 000 519 246 www.shf.org.au
MEDICAL ASSESSMENT FORM - for guidance only
Please retain PART 1 for your records
Sign and give PART 2 to your patient to be returned
PART 1
Patient's name: ……………………………………………………………………………………
Date of birth: …………………………………………………
Sex : …………………………
MEDICAL HISTORY - for guidance only
1 : Do you suffer from any illness or disability (includes visual or hearing impairment)?
2:
Are you currently receiving any medication or other treatment?
3:
Have you had any of the following?
Asthma - degree: slight/mild/severe
Hay fever
Severe reaction to drugs
or injections - specify
Epilepsy, fits or convulsions
Giddiness
Tendency to bleed or bruise easily
Heart disease
Severe headaches, migraines
Food intolerance or allergy
Fainting attacks or blackouts
Sleepwalking, sleep disturbances
Diabetes
Travel sickness - car/plane/sea
Joint, muscle, bone or back problems
If YES to any of the above, further details:…………………………………………………
……………………………………………………………………………………………….
…………………………………………………………………………………………………………..
EXAMINATION
4:
We would expect your assessment to include:
BP, urinalysis, pulse, weight, visual acuity, colour vision, Tetanus immunisation status
Sydney Maritime Museum Limited trading as Sydney Heritage Fleet ABN 70 000 519 246 wwwaustfieet.com
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PART 2
Doctor - Please complete & attach this section to your letterhead
Passenger name:………………………………………………………………………………
Date of birth: …………………………………………………….. Sex: …………………………
DOCTOR'S CONCLUSION -James Craig medical assessment
1: Is the passenger fit to undertake a voyage(s) on the James Craig
YES
NO
2: Are there any conditions/restrictions you would recommend?
YES
NO
If YES, please give details:………………………………………………………………………….
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Doctor's name (please print) ………………………………………………………………………..
Doctor's address:…………………………………………………………………………………….
Doctor's signature:………………………………………….. Date:………………………………
26/9/14
Sydney Maritime Museum Limited trading as Sydney Heritage Fleet ABN 70 000 519 246 www.shf.org.au