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Connecticut Request for Medical Disqualification from Jury Service

Ct Jury Duty Exemption Form

Name: Connecticut Request for Medical Disqualification from Jury Service
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.86 (217 reviews)

Category:

Connecticut Statewide - General

State:

Connecticut

Control #:

CT-JD-JA-47

Format:

Instant download

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Public form

Description Ct Jury Duty Medical Disqualification Form

Request for Medical Disqualification from Jury Service The Connecticut Request for Medical Disqualification from Jury Service is an application to the court in order to be excused from jury duty due to a medical condition. It is available as a form for a prospective juror to fill out in order to prove to the court that they are unable to serve as a juror. This form must be completed and signed by a physician. It must also include a detailed medical diagnosis and prognosis, and any other information relevant to the medical condition that renders the prospective juror unable to serve on a jury. There are two types of Connecticut Request for Medical Disqualification from Jury Service: Permanent and Temporary. A Permanent Medical Disqualification is a permanent exemption from jury service due to a medical condition that is not expected to improve. A Temporary Medical Disqualification is for a period of time due to a medical condition that is expected to improve. In either case, the physician must provide information detailing the medical condition and prognosis.

The Connecticut Request for Medical Disqualification from Jury Service is an application to the court in order to be excused from jury duty due to a medical condition. It is available as a form for a prospective juror to fill out in order to prove to the court that they are unable to serve as a juror. This form must be completed and signed by a physician. It must also include a detailed medical diagnosis and prognosis, and any other information relevant to the medical condition that renders the prospective juror unable to serve on a jury. There are two types of Connecticut Request for Medical Disqualification from Jury Service: Permanent and Temporary. A Permanent Medical Disqualification is a permanent exemption from jury service due to a medical condition that is not expected to improve. A Temporary Medical Disqualification is for a period of time due to a medical condition that is expected to improve. In either case, the physician must provide information detailing the medical condition and prognosis.

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How to fill out Connecticut Request For Medical Disqualification From Jury Service?

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Jury Duty Medical Exemption Form Rating

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FAQ

If you're over 18 years old, you can be called for jury service. Some people aren't eligible for jury service or can get excused because of their job. There's no automatic exemption from jury service for being elderly. You can ask to be excluded when you're over 70.

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.

Connecticut has a list of specific excuses that can be used to be exempt from reporting for jury duty, including excuses for student, age, police, medical worker and firefighter. You can also be excused if you don't meet the basic eligibility requirements for jury duty in CT.

What happens if I do not report for jury service? Not going to court on the date you have been summoned for jury service is a violation of state law and you may be ordered to pay a fine.

Please notify the court in writing by e-mail or U.S. Mail. Be sure to include your telephone number because, the jury clerk may need to discuss accommodations with you. You may request to be excused if you are disabled and jury service would be an undue hardship or extreme inconvenience.

Dear Office of Jury Commissioner: I am a physician treating Juror Name for identify general nature of medical condition - specific diagnosis is not required.. This medical condition is a permanent medical condition. In my opinion, Juror Name will never be able to perform juror service.

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Must be a citizen of the United States of America, at least 18 years of age, who has resided for a period of one year within the judicial district; You should mail this form as soon as possible to: U.S. District Court, 324 W. Market St., Greensboro, NC 27401 Attn: Jury.To request a medical disqualification, please fill out Part I of this form and have a licensed health care provider complete. Part II of this form. 40.013 Persons disqualified or excused from jury service. If you're the sole caregiver for a person with a medical disability in your household, you can request to be disqualified from jury duty. Serving on a jury is an important civic duty. Find out who is eligible for jury duty, how to respond to your summons, and what to expect when you serve. Hidalgo County can try to accommodate anyone with a medical problem or a disability to help them complete their jury service. All requests must be submitted to the Jury Commissioner's Office in writing prior to the prospective juror's service date.

Ct Jury Duty Exemption Form

Description Ct Jury Duty Medical Disqualification Form

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