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I am writing to request an excuse from jury duty on the grounds that such jury services would pose an undue hardship on me and an extreme inconvenience to the patients of my dental practice. I am a sole practitioner and have no other dentists in my office who can treat my patients if I am not here.
When writing your or your employee's jury duty excuse letter, you must include basic information like the juror number, date, and your mailing address. You also need to include the clerk's information. Include detailed information about why you or your employee needs to be excused from serving jury duty.
Excuse from Service You have no means of transportation. You would have to travel an excessive distance to the courthouse. You have a physical or mental impairment. You provide care for a dependent and cannot afford to have someone cover for you. Serving would be an extreme financial burden.
(c) Process for requesting permanent medical excuse The supporting letter, memo, or note must be on the treating health care provider's letterhead, state that the person has a permanent disability that makes the person incapable of performing jury service, and be signed by the provider.