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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
The process for requesting a permanent medical excuse from jury service is as follows: (1) An applicant must submit to the jury commissioner a written request for permanent medical excuse with a supporting letter, memo, or note from a treating health care provider.
How Can I Get Out of Jury Duty? Lack of transportation to and from the courthouse; You would have to travel an excessive distance to get to the courthouse; You have a mental or physical limitation or disability; You provide care for a dependent child or adult and are unable to find help to care for your dependent;
Minor hardships or inconveniences to an employer are not legal reasons to be excused from jury service. However, you may request to be postponed to a more convenient time. If serving on jury duty will create an extreme financial hardship, visit the online Juror Portal to request an excuse.
You may be excused if you have a serious health problem. If you are sick or injured, you may postpone your service or request an excuse. If you are disabled, you may request a permanent medical excuse. Follow the directions on the summons for postponement or excuse.
For example, write something like “My name is Jane Doe. On (date), I received a jury summons for (court date) at (court address) and was assigned the juror number (insert number here). I am writing to request to be excused from jury service because being absent from work would pose an extreme financial hardship.”
All requests to be excused from jury service that are granted for undue hardship must be put in writing by the prospective juror, reduced to writing, or placed on the court's record.
Prospective jurors are put under oath when they are questioned (subjected to a void dire examination), so any prospective juror who lies could be prosecuted for perjury (a five-year felony in federal court).
When writing a jury excuse letter, directly state why you cannot serve and how serving would lead to hardship. Valid exemptions include being ill or disabled, being the sole guardian of young children, or being over the age of 70. Include documentation such as a doctor's note or a letter from an employer.
You will automatically be assigned a new date for jury duty if you do not respond. Further failure to appear could result in punishment by fine, incarceration or both. Fines can start at $250 with a maximum of $1500.