Sample Medical Excuse Letter For Jury Duty

Sample Medical Excuse Letter for Jury Duty: A Comprehensive Guide

Facing jury duty while dealing with a medical condition can be stressful. Navigating the legal requirements and crafting a compelling excuse letter can feel overwhelming. This comprehensive guide provides you with a sample medical excuse letter for jury duty, along with crucial information to ensure your request is processed effectively. We'll cover the essential elements needed for a successful application, emphasizing clarity, accuracy, and professionalism. Learn how to articulate your health concerns while adhering to legal protocols. This guide will equip you with the knowledge to navigate this potentially challenging situation confidently.

Understanding the Process: Why You Need a Doctor's Note

Before diving into sample letters, it's crucial to understand the process. Simply stating you're unwell isn't sufficient. Most courts require documentation from a licensed medical professional to verify your claim. This is where a well-crafted medical excuse letter becomes indispensable. The letter acts as objective evidence supporting your request for deferral or exemption from jury duty. Failing to provide adequate documentation may result in a summons for contempt of court, highlighting the importance of a properly prepared letter.

Essential Components of a Strong Medical Excuse Letter

A successful medical excuse letter should contain specific elements to ensure its acceptance. These include:

H3: Accurate Identification and Contact Information:

Begin with your full name, address, phone number, and email address. This ensures the court can easily contact you if further information is required. Accuracy is paramount – any discrepancies can delay the process.

H3: Clear Statement of Purpose:

Clearly state your purpose – requesting a deferral or exemption from jury duty due to a medical condition. Be direct and unambiguous in your request.

H3: Detailed Description of Medical Condition:

Provide a concise yet comprehensive description of your medical condition. Include the diagnosis, symptoms, and any relevant treatment details. Vague statements are less likely to be accepted. For example, instead of writing "I'm not feeling well," specify your diagnosis and its impact on your ability to perform jury duty.

H3: Doctor's Certification and Credentials:

The letter must include your doctor's information: their full name, medical license number, contact details (phone number, address, and ideally, fax number), and practice address. This verifies the letter's legitimacy.

H3: Impact on Jury Duty:

Clearly articulate how your medical condition hinders your ability to fulfill jury duty responsibilities. Explain any limitations, such as difficulty concentrating, physical limitations that affect your ability to sit for extended periods, or the need for frequent medical attention.

H3: Request for Deferral or Exemption:

Specifically request a deferral (postponement) or exemption (release) from jury duty, indicating your preferred option. If requesting a deferral, suggest a suitable timeframe.

Sample Medical Excuse Letter for Jury Duty

[Your Name]
[Your Address]
[Your Phone Number]
[Your Email Address]

[Date]

[Court Clerk's Name]
[Court Name]
[Court Address]

Subject: Request for Deferral/Exemption from Jury Duty – [Your Name] – [Case Number, if applicable]

Dear [Court Clerk's Name],

This letter is to formally request a deferral/exemption from jury duty due to a medical condition. I received a summons for jury duty on [Date of Summons] with case number [Case Number, if applicable].

I am currently under the care of Dr. [Doctor's Name], [Doctor's Title], whose contact information is provided below:

Dr. [Doctor's Name]
[Doctor's Address]
[Doctor's Phone Number]
[Doctor's Fax Number (if available)]
[Doctor's License Number]

My diagnosis is [Your Diagnosis]. This condition is characterized by [brief description of symptoms and its impact on your ability to serve]. This significantly impairs my ability to fully participate in jury duty proceedings, particularly [explain specific difficulties, e.g., concentration, prolonged sitting]. A copy of my doctor's supporting statement is attached.

Therefore, I respectfully request a deferral/exemption from jury duty until [Proposed Date for Deferral, if applicable].

Thank you for your time and consideration.

Sincerely,

[Your Signature]
[Your Typed Name]

Important Considerations

Attach supporting medical documentation: Always attach a separate letter from your physician directly to your request. This letter should corroborate the information you provide.
Be truthful and accurate: Provide accurate information and avoid exaggeration. False statements can have serious consequences.
Maintain professionalism: Use a formal tone and avoid emotional language.
Follow court guidelines: Familiarize yourself with your specific court's procedures for requesting a deferral or exemption.

Conclusion

Obtaining a medical excuse for jury duty requires careful preparation and adherence to legal protocols. By following the guidelines outlined in this article and providing a clear, well-supported request, you significantly increase your chances of a successful outcome. Remember, honesty and accuracy are paramount in this process.

FAQs

Q1: Can I use a generic sample letter? No. You need a letter tailored to your specific medical condition and supported by your doctor's statement. Generic letters are unlikely to be accepted.

Q2: What if my doctor refuses to write a letter? Explore the reasons behind their refusal. If there's a misunderstanding, clarify the court's requirements. If they still refuse, you may need to seek a second medical opinion.

Q3: How long does it typically take for a court to respond to my request? The processing time varies depending on the court’s workload. Contact the court directly to inquire about their expected response time.

Q4: What happens if my request is denied? If your request is denied, you may need to consult with a legal professional to discuss your options.

Q5: Can I request a deferral rather than an exemption? Yes, you can request a deferral to a later date if your condition is temporary. Clearly state your preferred timeframe in your letter.


  sample medical excuse letter for jury duty: Through the Eyes of the Juror , 1998
  sample medical excuse letter for jury duty: Selection, Eligibility and Exemption of Jurors Law Reform Commission of Western Australia, 2009
  sample medical excuse letter for jury duty: Model Rules of Professional Conduct American Bar Association. House of Delegates, Center for Professional Responsibility (American Bar Association), 2007 The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
  sample medical excuse letter for jury duty: Blue's Guide to Jury Selection Lisa Blue, 2004
  sample medical excuse letter for jury duty: Jury Directions New South Wales. Law Reform Commission, 2012 This report is about the directions that judges give to juries in the course of a criminal trail, and particularly at the summing up. These directions are designed to help jurors understand as much of the law and the issues that arise in the case as they need to make proper use of the evidence and to reach a verdict.
  sample medical excuse letter for jury duty: Handbook for federal grand jurors , 2003
  sample medical excuse letter for jury duty: Juror's Handbook Lynn Buchanan, 2005-01-01 Jury service is one of the most important civic duties a person can undertake, yet it is often poorly understood. This booklet has been prepared in consultation with the Juries Commissioner's Office. It answers frequently asked questions about jury service and provides prospective jurors with a clear explanation of their responsibilities and the processes involved in trials. All potential jurors will receive a copy when they attend for jury service.
  sample medical excuse letter for jury duty: Jury Trial Innovations G. T. Munsterman, 1997
  sample medical excuse letter for jury duty: United States Attorneys' Manual United States. Department of Justice, 1985
  sample medical excuse letter for jury duty: Civil Trials Bench Book , 2007 This book provides guidance for judicial officer in the conduct of civil proceedings, from preliminary matters to the conduct of final proceedings and the assessment of damages and costs. It contains concise statements of relevant legal principles, references to legislation, sample orders for judicial official to use where suitable and checklists applicable to various kinds of issues that arise in the course of managing and conducting civil litigation.
  sample medical excuse letter for jury duty: Michigan Court Rules Kelly Stephen Searl, William C. Searl, 1922
  sample medical excuse letter for jury duty: The Jury Process Nancy S. Marder, 2005 This book gives a complete overview of America's jury system. It has three instructional goals: to show where the jury stands in America's rich legal history, to explain the defining features of today's jury, and to identify aspects of the jury where improvements can and should be made. It can be used as a primary textbook for a course, or as a supplement in any law school course that includes a unit on the jury.
  sample medical excuse letter for jury duty: EBOOK: A Sociology of Mental Health and Illness Anne Rogers, David Pilgrim, 2014-05-16 How do we understand mental health problems in their social context? A former BMA Medical Book of the Year award winner, this book provides a sociological analysis of major areas of mental health and illness. The book considers contemporary and historical aspects of sociology, social psychiatry, policy and therapeutic law to help students develop an in-depth and critical approach to this complex subject.New developments for the fifth edition include: Brand new chapter on prisons, criminal justice and mental health Expanded coverage of stigma, class and social networks Updated material on the Mental Capacity Act, Mental Health Act and the Deprivation of Liberty A classic in its field, this well established textbook offers a rich and well-crafted overview of mental health and illness unrivalled by competitors and is essential reading for students and professionals studying a range of medical sociology and health-related courses. It is also highly suitable for trainee mental health workers in the fields of social work, nursing, clinical psychology and psychiatry. Rogers and Pilgrim go from strength to strength! This fifth edition of their classic text is not only a sociology but also a psychology, a philosophy, a history and a polity. It combines rigorous scholarship with radical argument to produce incisive perspectives on the major contemporary questions concerning mental health and illness. The authors admirably balance judicious presentation of the range of available understandings with clear articulation of their own positions on key issues. This book is essential reading for everyone involved in mental health work. Christopher Dowrick, Professor of Primary Medical Care, University of Liverpool, UK Pilgrim and Rogers have for the last twenty years given us the key text in the sociology of mental health and illness. Each edition has captured the multi-layered and ever changing landscape of theory and practice around psychiatry and mental health, providing an essential tool for teachers and researchers, and much loved by students for the dexterity in combining scope and accessibility. This latest volume, with its focus on community mental health, user movements criminal justice and the need for inter-agency working, alongside the more classical sociological critiques around social theories and social inequalities, demonstrates more than ever that sociological perspectives are crucial in the understanding and explanation of mental and emotional healthcare and practice, hence its audience extends across the related disciplines to everyone who is involved in this highly controversial and socially relevant arena. Gillian Bendelow, School of Law Politics and Sociology, University of Sussex, UK From the classic bedrock studies to contemporary sociological perspectives on the current controversy over which scientific organizations will define diagnosis, Rogers and Pilgrim provide a comprehensive, readable and elegant overview of how social factors shape the onset and response to mental health and mental illness. Their sociological vision embraces historical, professional and socio-cultural context and processes as they shape the lives of those in the community and those who provide care; the organizations mandated to deliver services and those that have ended up becoming unsuitable substitutes; and the successful and unsuccessful efforts to improve the lives through science, challenge and law. Bernice Pescosolido, Distinguished Professor of Sociology, Indiana University, USA
  sample medical excuse letter for jury duty: The Medical times , 1851
  sample medical excuse letter for jury duty: British Medical Journal , 1886
  sample medical excuse letter for jury duty: Medical Times , 1851
  sample medical excuse letter for jury duty: National Board of Health Magazine , 1897
  sample medical excuse letter for jury duty: Pharmaceuticals, Corporate Crime and Public Health Graham Dukes, John Braithwaite, J P Moloney, 2014-06-27 The pharmaceutical industry exists to serve the community, but over the years it has engaged massively in corporate crime, with the public footing the bill. This readable study by experts in medicine, law, criminology and public health documents the pr
  sample medical excuse letter for jury duty: Casebook on Human Dignity and Human Rights , 2011
  sample medical excuse letter for jury duty: The Ultimate Guide To Choosing a Medical Specialty Brian Freeman, 2004-01-09 The first medical specialty selection guide written by residents for students! Provides an inside look at the issues surrounding medical specialty selection, blending first-hand knowledge with useful facts and statistics, such as salary information, employment data, and match statistics. Focuses on all the major specialties and features firsthand portrayals of each by current residents. Also includes a guide to personality characteristics that are predominate with practitioners of each specialty. “A terrific mixture of objective information as well as factual data make this book an easy, informative, and interesting read.” --Review from a 4th year Medical Student
  sample medical excuse letter for jury duty: Civil Appeals Michael Burton, 2011-12-01 Any practitioner faced with the decision as to whether to appeal, or who has questions arising at each stage, will benefit enormously from a book that examines the law, principles, procedures, and processes involved. This leading work has been updated and restructured, to ensure it provides guidance on the complete and complex process of making a civil appeal. Clearly written and cross referenced, the books UK/European coverage of appeals includes: -- District Judges to Circuit Judges in the County Court -- Masters and District Judges to High Court Judges -- Court of Appeal -- House of Lords -- Privy Council -- The European Court -- The European Court of Human Rights -- Administrative Law and Elections
  sample medical excuse letter for jury duty: The Medical Times and Gazette , 1851
  sample medical excuse letter for jury duty: Empire of Pain: The Secret History of the Sackler Dynasty Patrick Radden Keefe, 2021-04-27 The inspiration behind the Netflix TV series Painkillers, starring Uzo Aduba and Matthew Broderick. Amazon's Top 20 Best Books of the Year 'This is no dense medical tome, but a page-turner with a villainous family to rival the Roys in Succession, and one where every chapter ends with the perfect bombshell.' Esquire The highly-anticipated portrait of three generations of the Sackler family, by the prize-winning, bestselling author of Say Nothing. The Sackler name adorns the walls of many storied institutions - Harvard; the Metropolitan Museum of Art; Oxford; the Louvre. They are one of the richest families in the world, known for their lavish donations in the arts and the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing Oxycontin, a blockbuster painkiller that was a catalyst for the opioid crisis-an international epidemic of drug addiction which has killed nearly half a million people. In this masterpiece of narrative reporting and writing, Patrick Radden Keefe exhaustively documents the jaw-dropping and ferociously compelling reality. Empire of Pain is the story of a dynasty: a parable of 21st century greed. WINNER OF THE BAILLIE GIFFORD PRIZE FOR NON-FICTION 2021 SHORTLISTED FOR THE FT & MCKINSEY BUSINESS BOOK OF THE YEAR AWARD 2021 ONE OF BARACK OBAMA'S FAVOURITE BOOKS OF 2021 SHORTLISTED FOR THE BAILLIE GIFFORD 'WINNER OF WINNERS' AWARD PRAISE FOR EMPIRE OF PAIN 'In this mesmerizing history of the Sackler Family-the founders and masterminds behind OxyContin-Radden Keefe spins a shocking and edifying story of ambition, power, deception, and greed that reads like fiction.' Al Woodworth, Senior Editor at Amazon (Amazon's Top 20 Best Books of the Year) 'The story of the Sacklers and OxyContin is a parable of the modern era of philanthropy being deployed to burnish the reputations of financiers and entrepreneurs . . . [A] tour-de-force' - Financial Times 'There are so many they did what? moments in this book, when your jaw practically hits the page' - Sunday Times 'Put simply, this book will make your blood boil....a devastating portrait of a family consumed by greed and unwilling to take the slightest responsibility or show the least sympathy for what it wrought....a highly readable and disturbing narrative.' John Carreyrou, bestselling author of Bad Blood 'Empire of Pain reads like a real-life thriller, a page-turner, a deeply shocking dissection of avarice and calculated callousness... It is the measure of great and fearless investigative writing that it achieves retribution where the law could not....Exhaustively researched and written with grace and gravity, Empire of Pain unpeels a most terrible American scandal. You feel almost guilty for enjoying it so much.' - The Times (London) 'An engrossing and deeply reported book about the Sackler family, the owners of Purdue Pharma. Their company created Oxycontin, the opioid introduced in the mid-90s that sent a wave of addiction and death across the country. Unlike previous books on the epidemic, Empire of Pain is focused on the wildly rich, ambitious and cutthroat family that built its empire first on medical advertising and later on painkillers. In his hands, their story becomes a great American morality tale about unvarnished greed dressed in ostentatious philanthropy.' - The New York Times 'A brutal, multigenerational treatment of the Sackler family... Keefe deepens the narrative by tracing the family's ambitions and ruthless methods back to the founding patriarch, Arthur Sackler...His life might be a model for the American dream, if it hadn't arguably laid the foundations for a still-unfolding national tragedy.' - NPR
  sample medical excuse letter for jury duty: Criminal Trial Delays in Australia Jason Payne, 2007-01-01 This research examines the reasons for which criminal trials in Australia fail to proceed on the day of listing. The rationale of such an inquiry is that matters that fail to proceed as scheduled contribute to backlog and delay, both of which consume significant criminal justice resources. Moreover, delay in the criminal trial system may result in adverse effects, not the least of which is the anguish endured by the victims of crime and their families, and the community demanding protection from criminal offenders. This research used quantitative data from courts across a number of Australian states and territories to demonstrate that more than half of all listed criminal trials fail to commence on the listed day. After an analysis of data about trials and extensive interviews with court administrators, it is found that those trials that do not proceed can be placed into two categories: those trials that are finalised on or near the trial date either by way of late guilty plea or late withdrawal by the prosecution, and those trials that are adjourned and re-listed. While some delays will be inevitable, the report builds on recommendations made by a working group of the Standing Committee of Attorneys-General to suggest ways of reducing the backlog of criminal trials across Australia.
  sample medical excuse letter for jury duty: Costs of Prosecution United States. Internal Revenue Service. Criminal Investigation Division, 1989
  sample medical excuse letter for jury duty: Youth's Companion , 1878
  sample medical excuse letter for jury duty: Prisoner Handbook , 2018
  sample medical excuse letter for jury duty: The Professor Is In Karen Kelsky, 2015-08-04 The definitive career guide for grad students, adjuncts, post-docs and anyone else eager to get tenure or turn their Ph.D. into their ideal job Each year tens of thousands of students will, after years of hard work and enormous amounts of money, earn their Ph.D. And each year only a small percentage of them will land a job that justifies and rewards their investment. For every comfortably tenured professor or well-paid former academic, there are countless underpaid and overworked adjuncts, and many more who simply give up in frustration. Those who do make it share an important asset that separates them from the pack: they have a plan. They understand exactly what they need to do to set themselves up for success. They know what really moves the needle in academic job searches, how to avoid the all-too-common mistakes that sink so many of their peers, and how to decide when to point their Ph.D. toward other, non-academic options. Karen Kelsky has made it her mission to help readers join the select few who get the most out of their Ph.D. As a former tenured professor and department head who oversaw numerous academic job searches, she knows from experience exactly what gets an academic applicant a job. And as the creator of the popular and widely respected advice site The Professor is In, she has helped countless Ph.D.’s turn themselves into stronger applicants and land their dream careers. Now, for the first time ever, Karen has poured all her best advice into a single handy guide that addresses the most important issues facing any Ph.D., including: -When, where, and what to publish -Writing a foolproof grant application -Cultivating references and crafting the perfect CV -Acing the job talk and campus interview -Avoiding the adjunct trap -Making the leap to nonacademic work, when the time is right The Professor Is In addresses all of these issues, and many more.
  sample medical excuse letter for jury duty: The Saxon Thief Martin Turner, 2017-07-21 By hook or by bishop's crook, Ventianus will see him dead by nightfall. While Cuthbert and Eadmund pursue a thief through the deserted streets of an enemy city, others plot to turn their help into harm and their honour into shame. Outwitted and outnumbered, they stumble into a nest of conspiracies that may send Britain crashing back into the bloodshed and chaos from which it just emerged. But Eadmund has more in the game than Cuthbert knows, and deciding who to trust may become the most dangerous choice of all.Every treasure has a secret, every saint has a past.
  sample medical excuse letter for jury duty: Americans with Disabilities Act Title II Regulations United States. Department of Justice, 2015-01-07 This revised title II regulation integrates the Department of Justice's new regulatory provisions with the text of the existing title II regulation that was unchanged by the 2010 revisions. Includes a section for guidance and analysis.
  sample medical excuse letter for jury duty: Model Civil Jury Instructions for the District Courts of the Third Circuit , 2006
  sample medical excuse letter for jury duty: Chemist and Druggist , 1895
  sample medical excuse letter for jury duty: Pattern Jury Instructions , 1997
  sample medical excuse letter for jury duty: Uniform Evidence Law Miiko Kumar, Stephen Odgers, Elisabeth Peden, 2015 Uniform Evidence Law: Commentary and Materials, 5th editionhas been updated throughout to provide essential case and legislative extracts and thoughtful, concise commentary covering the uniform evidence legislation in the UEL jurisdictions of the Commonwealth, New South Wales, Victoria and Tasmania.
  sample medical excuse letter for jury duty: Jury Selection in Criminal Trials David M. Tanovich, David M. Paciocco, Steven Skurka, 1997 This practical guide for practitioners and the judiciary provides readers with guidance on all aspects of jury selection, from the initial decision to select trial by jury to challenges for cause and peremptory challenges.
  sample medical excuse letter for jury duty: Nevada Jury Instructions - Civil State Bar of Nevada. Nevada Jury Instructions--Civil Subcommittee, 2011-02-07
  sample medical excuse letter for jury duty: Majority Verdicts New South Wales. Law Reform Commission, 2005 It is generally considered that the requirement of unanimity results in more hung juries than does the alternative system of requiring only a majority of jurors to agree on a verdict. What constitutes a majority differs between jurisdictions that have embraced the concept, and may also depend on the type of offence being tried. This Report examines arguments for and against preserving the unanimity rule.
  sample medical excuse letter for jury duty: Justice of the Peace , 1975
  sample medical excuse letter for jury duty: Japan Weekly Mail , 1897
  sample medical excuse letter for jury duty: The Advocate , 2001-08-14 The Advocate is a lesbian, gay, bisexual, transgender (LGBT) monthly newsmagazine. Established in 1967, it is the oldest continuing LGBT publication in the United States.
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Jury Duty Medical Excuse Letter Sample Michael A. Olivas Federal Jury Service United States. Congress. House. Committee on the Judiciary. Subcommittee No. 5,1971 The Boston Medical …

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jury med excuse form - California
DATE OF JURY SUMMONS:_____ 1. The above-named person is under my care for a medical or health condition and is not able to serve jury duty because: 2. Please state why the condition …

BRING ENTIRE FORM WHEN YOU REPORT juror badge
permanent medical excuse from jury service (California Rules of Court, rule 2.1009) will ALWAYS receive a response. Please submit a permanent medical excuse request separately, along with …

REQUEST FOR MEDICAL EXCUSE FROM JURY SERVICE
REQUEST FOR MEDICAL EXCUSE FROM JURY SERVICE TO BE COMPLETED BY DOCTOR’S OFFICE ONLY Describe any mobility, physical or mental restrictions that make …

OSCEOLA COUNTY JURY SERVICES DEPARTMENT - Ninth …
(PLEASE EXPLAIN WHY CONDITION PREVENTS JURY SERVICE.) _____ _____ _____ The undersigned states in good faith that the Juror has a medical condition that prevents the Juror …

Jury Duty for Family Child Care Providers - Public Counsel
jury duty will be excused. To determine whether the financial hardship will be considered extreme and jury duty excused, the Jury Commissioner or judge will consider the a) sources of the child …

EXCUSAL/POSTPONEMENT OF JURY DUTY FOR NON …
You may request to postpone jury duty for up to six months. Please indicate what month you will be available for jury duty within the next six months. You may call (772-462-6983) to get …

JURY EXCUSE FORM - judgechaney.com
JURY EXCUSE FORM If you would like to request to be excused from jury duty, please complete and submit appropriate ... (601.630.8033) a medical excuse. 11. Jury service would cause …

Medical Excuse/Exemption Form - .NET Framework
Medical Excuse/Exemption Form ... IF YOU ARE PHYSICALLY AND/OR MENTALLY UNABLE TO APPEAR FOR JURY SERVICE, HAVE YOUR PHYSICIAN COMPLETE THE …

If you are requesting to be excused from jury duty because …
OFFICE OF JURY SERVICES P.O. Box 4988 San Rafael, CA 94913-4988 (415) 444-7120 • Email: jury@marin.courts.ca.gov REQUEST FOR MEDICAL EXCUSE FROM JURY DUTY If …

Sample Medical Excuse Letter For Jury Duty .pdf
Sample Medical Excuse Letter For Jury Duty The Medical Times and Gazette ,1851 Medical Times ,1851 Through the Eyes of the Juror ,1998 Criminal Procedure (Scotland) Act 1995 …

LA Court
Created Date: 3/29/2019 8:27:38 AM

Sample Letter from Health Care Professional Supporting …
You may provide this sample letter to your health care professional to help him or her document your disability and need for reasonable accommodations. This documentation should be on …

Affidavit for Excuse or Deferral from Jury Duty – Child Care …
00 0000000 COUNTN, STATE COURT OF FULTON COUNTY ATLANTA, GEORGIA . Author: Battle, Adasha Created Date: 2/2/2024 3:09:33 PM

Complete if family member died within LosAngeles County
If you are requesting an excuse or transfer by phone, y ou will be required to . complete and return your jury summons form. See below for the sections that require completion for each …

CONFIDENTIAL Jury Questionnaire Superior Court of …
Temporary Medical Excusal – Health care providers note required. Permanent Medical Excusal – Health care providers note required. Permanent Medical Excusal – 70 years of age or older. …

REQUEST FOR MEDICAL EXCUSE FROM JURY SERVICE
REQUEST FOR MEDICAL EXCUSE FROM JURY SERVICE If a patient requests to be excused from jury service for reasons related to mental or physical condition a written statement from a …

JUROR REQUEST FOR EXCUSAL DUE TO MEDICAL DISABILITY …
This request must be submitted to the Jury Division seven (7) days before the Juror/Patient is to report to jury duty. It is the responsibility of the Juror/Patient to assure this request is received …

Kings County Clerk Division of Jurors Supreme Court …
cases in which jurors are excused from jury service for medical reasons. We cannot excuse potential jurors “at their word” and require specific medical documentation to remove a person …

Jury Duty: Breastfeeding and Lactation Accommodations
child” can delay jury duty for up to one year, and can ask for an extension after her infant is one year old . The law also requires that the exemption for breastfeeding be part of the standard …

Affidavit for Excuse or Deferral from Jury Duty – Student
school, or other post-secondary school and that I request to be deferred from jury duty. I further affirm that my post-secondary education will be completed on or about _____. Student …

Certification in Support of Request to be Excused from Jury …
New Jersey law permits an excuse from jury service based upon severe financial hardship, as follows: Jury service will impose a severe financial hardship, which will compromise the juror’s …

Jury Duty Medical Excuse Form - Sample Templates
Jury Duty Medical Excuse Form Date: RE: Address: Jury Commissioner, This is to inform you that the patient listed above has been excused from Jury Duty due to this medical condition: _____ …

AFFIDAVIT FOR EXEMPTOIN FROM JURY DUTY
PHYSICIANS STATEMENT FOR MEDICAL EXEMPTION FROM JURY DUTY . Govt. code 62.109 (b). A person requesting an exemption under this section must submit to the court an …

THE ANSWER BOOK FOR JURY SERVICE - Virginia’s Judicial …
summoned and appear for jury. duty for four or more hours in one. day, including travel time, your. employer may not require you to. start any work shift that begins at. or after 5:00 p.m. on the …

Sample Letter - Permanent Medical Disqualification - ExcelSHE
Office of Jury Commissioner 560 Harrison Avenue, Suite 600 Boston, Massachusetts 02118 Re: [Juror Name] [Juror Badge Number] Dear Office of Jury Commissioner: I am a physician …