TSAKOS COLUMBIA SHIPMANAGEMENT (“TCM”) S.A.

Issue No: 02
SHIPBOARD CONTINGENCY PLAN CHECKLIST Date effective: 01/05/2014
Checklist CPM/K
MEDICAL MATTERS / INJURY Page: 1 of 1

Actions Responsible YES NO N/A

Person

1. Call the Master OOW

2. Name and rank of sick / injured crew member CH.OFF

3. Nature of illness or cause of injury (Full description) CH.OFF

4. Contact shore stations or ships with doctor on board for medical MASTER
advice, describe treatment recommended
5. Report condition ever 6hrs, if necessary Bridge
Watch

6. Date of allotment of medicine. Treatment recommended CH.OFF

7. Assistance required. (Medical Advice or Helicopter for landing) MASTER

8. Prepare deviation statement, if necessary and Master’s report MASTER

9. Inform the Emergency Duty Person or the DPA. MASTER

10. Eye witnesses statements SAF.OFF

11. Illness / Injury Form to be completed SAF.OFF

12. Prepare account of wages MASTER

13. Prepare personal effect inventory signed by Master and two MASTER
witnesses
14. Enter facts in medical log and deck log book OOW

15. Request instructions from office where to forward wages and MASTER
personal effects