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How to use or fill out REQUEST FOR MEDICAL DISQUALIFICATION FROM JURY SERVICE

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Click ‘Get Form’ to open it in the editor.
In Part I, enter your name, address, and juror identification number. Ensure all information is accurate to avoid delays.
Provide your date of birth and clearly state your claim for disqualification due to physical or mental disability.
Next, print the form and have a licensed health care provider complete Part II. They must provide their opinion on your ability to serve as a juror.
Ensure that the health care provider selects whether you should be disqualified for one year or permanently. This section must be legible for processing.
Once completed, save the document and either fax it to Jury Administration at (860) 263-2770 or email it to Jury.Administration@jud.ct.gov. You may also mail it directly.

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Can a doctors note for anxiety get you out of jury duty?

0:33 3:34 Note this note should explain the severity of your anxiety. And how it affects your ability to serveMoreNote this note should explain the severity of your anxiety. And how it affects your ability to serve as a juror. Most doctors will have no problem providing this if youre honest about your condition.

What health conditions exempt you from jury duty?

1:12 3:50 In other jurisdictions. Like Idaho you also need to provide a medical excuse from your physician. IfMoreIn other jurisdictions. Like Idaho you also need to provide a medical excuse from your physician. If you want to be excused from jury duty due to a physical or mental disability.

What are three things that disqualify someone from being on a jury?

1. The prospective juror is a convicted felon. 2. Knows one or more of the parties to the legal action. 3. Is related to the presiding judge., 4. Dislikes persons that are the color, race, religion or social group to which one or more of the parti

Whats the best excuse to use to get out of jury duty?

A prospective juror may be excused if he/she: Has a physical or mental disability that would prevent him/her from serving. Must provide actual and necessary care for another and alternate arrangements are not feasible. Is unable to read or understand the English language. Over 75 years of age.

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