Ct jury form 2026

1. Click ‘Get Form’ to open the ct jury form in the editor.
2. In Part I, enter your name, address, and juror identification number. Ensure all information is accurate for proper processing.
3. Provide your date of birth and state your claim for disqualification due to physical or mental disability. This section is crucial for establishing your eligibility.
4. Next, have a licensed health care provider complete Part II. They must provide their opinion on your ability to serve as a juror and indicate whether you should be disqualified temporarily or permanently.
5. Ensure that the health care provider fills in their name, title, business address, and telephone number clearly. Their signature and date are also required for validation.
6. Once completed, save the form 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 if preferred.

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