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Kaiser jury duty excuse 2026

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The document is a Jury Duty Medical Excuse Form issued by Kaiser Permanente Fresno Medical Center, indicating that a patient is excused from jury duty due to a medical condition. It includes sections for the physician's signature and options for future service.

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Click ‘Get Form’ to open the kaiser jury duty excuse in the editor.
Begin by entering the date at the top of the form. This is essential for record-keeping.
In the 'RE:' section, input the name of the patient who is being excused from jury duty.
Fill in the patient's address accurately to ensure proper communication with the Jury Commissioner.
Clearly state the medical condition that warrants an excuse from jury duty in the designated space.
Select one of the options regarding future service: indicate if they could serve at a later date or should never serve.
Finally, have the attending physician sign and date at the bottom of the form to validate it.

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