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