Excuse

If you are over 70 years of age and medical issues prevent you from serving, you are not required to provide a doctor's note. Complete and return the Jury Questionnaire, stating your date of birth and your request for excuse. Mail this form to the Jury Office within 10 days of receipt of the questionnaire. If you have been summoned, call the Jury Commissioner, advise your age and medical request for excuse.

If you are under the age of 70 and have a medical disability that would prevent you from serving, you must provide a doctor's note verifying the disability. The medical note must indicate the permanent nature of your disability or, if temporary, the specific time period for which your medical excuse is valid.

Medical notes should be attached to your completed Jury Questionnaire and returned to the Jury Office as soon as possible

 

Sample Letter Excusing Juror for Medical Reasons

 

Superior Court of California

County of Siskiyou

P.O. Box 1026

Yreka, CA   96097

 

Date of Summons:

 

Dear Jury Commissioner:

 

Please excuse ______________________________, DOB: ______________, from your list of potential jurors for medical reasons. It is my medical opinion that he/she is unable to fulfill jury duties

 

PERMANENTLY ______________

 

TEMPORARILY _______________

 

If the excuse is temporary, it is for ____________ months.

 

Sincerely,