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Jury Duty Pre-Screening Questionnaire

  1. COVID-19 Pre-Screening Questionnaire
    Within the 14 days, have you experienced any of the following symptoms that cannot be attributed to another health condition (check all that apply):
  2. COVID-19 Related Excuse or Postponement
    If you are age 65 or older, or an individual with a serious underlying health condition, such as chronic lung disease, obesity, asthma, high blood pressure, diabetes, or those whose immune systems are compromised, such as by chemotherapy, or you have a particular vulnerability to COVID-19 and wish to be excused from jury service or request to postpone jury service please check the appropriate box below:
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  4. This field is not part of the form submission.