A medical excuse letter for jury duty needs to come from your treating healthcare provider, sit on official letterhead, identify you by name and juror number, describe how your condition prevents you from serving, and say whether the problem is temporary or permanent. That letter goes in with the excuse form from your summons, before the deadline printed on it. A vague note that says “patient cannot serve” will usually be rejected.
What the Letter Must Include
The letter is the evidence behind your request, so courts expect it to look and read like a professional medical document. Across federal and state courts, these are the elements that need to be on the page:
- Official letterhead showing the provider’s name, title or degree, office address, and phone number.
- Your full name and, if the court assigned one, your juror participant number or summons badge number.
- A brief description of the condition. You generally don’t need to disclose a specific diagnosis. Courts want to know what limits you, not your full history.
- How the condition prevents jury service. This is where most letters fall short. “Patient has a back condition” is not enough. “Patient cannot sit for more than 45 minutes without needing to lie flat” tells the court exactly why service won’t work.
- Duration. Say whether the condition is temporary or permanent, and if temporary, when you’re expected to be able to serve.
- The treating provider’s personal signature and the date.
The letter doesn’t have to come from a physician specifically. Many courts accept letters from any licensed treating provider, including nurse practitioners, physician assistants, and psychologists or psychiatrists for mental health conditions. Your summons will state the exact language your court uses, so check it before your provider drafts anything.
Sample Letter You Can Share With Your Provider
Hand this template to your healthcare provider and fill in the bracketed details. Providers often have their own format, which is fine as long as it covers the same ground.
[Provider’s Letterhead: Name, Credentials, Practice Name, Address, Phone]
[Date]
Jury Services Clerk
[Court Name and Address from Summons]
Re: Medical Excuse Request for [Your Full Name]
Juror Participant Number: [Number from Summons]
Dear Jury Services Clerk,
I am the treating [physician/nurse practitioner/etc.] for the above-named patient. [Patient Name] is currently under my care for a condition that affects [his/her/their] [mobility/cognition/stamina/other relevant function].
This condition prevents [Patient Name] from performing jury service because [specific limitation, e.g., “cannot sit upright for more than 30 minutes without severe pain and must recline frequently throughout the day,” or “requires medical treatments three times per week that cannot be rescheduled,” or “experiences cognitive impairment that prevents sustained concentration for more than short periods”].
[If temporary:] I expect this condition to resolve by approximately [date], at which time [Patient Name] should be able to serve.
[If permanent:] This condition is chronic and unlikely to improve. I respectfully request that [Patient Name] be permanently excused from jury service.
Please contact my office at [phone number] if you require additional information.
Sincerely,
[Provider Signature]
[Provider Printed Name, Degree]
[License Number, if required by the court]
What Qualifies as a Medical Reason
Courts look for conditions serious enough that sitting in a courtroom for hours, following testimony, deliberating with other jurors, or showing up reliably each day would be impossible or medically dangerous. Examples include conditions that limit mobility, cause severe chronic pain, require frequent medical treatment on a fixed schedule, or significantly impair concentration or cognition.
If your condition is temporary, expect the court to postpone your service rather than excuse you permanently. A broken leg, a scheduled surgery, or an acute illness usually results in a deferral to a later date. Permanent excusal is reserved for conditions unlikely to improve. Federal jury plans allow districts to excuse individuals whose service would cause “undue hardship or extreme inconvenience,” and a well-documented chronic or permanent medical condition fits within that language.1Office of the Law Revision Counsel. 28 USC 1863 – Plan for Random Jury Selection
Ask About Accommodations First
Before pursuing an excuse, know that courts are required to provide reasonable accommodations for disabilities. Federal courts offer sign language interpreters, assistive listening devices, and real-time transcription for jurors who are deaf or hard of hearing. Wheelchair-accessible courtrooms and modified schedules are available in many courthouses. If an accommodation would let you serve, the court may offer that option rather than granting an excuse. Your doctor’s letter should address whether accommodations could resolve the problem or whether your condition prevents service either way.
Filing It With the Court’s Forms
Along with the letter, fill out whatever paperwork came with your summons. This is usually a juror questionnaire, a request-for-excuse form, or both. Some federal courts provide a separate physician’s statement form that your doctor fills out instead of writing a freeform letter. Either format is typically acceptable.
The single most important thing on any court form is your participant number, sometimes called a badge number or juror ID. This number links your medical documentation to your summons record. Leave it off and the clerk’s office may not be able to match your excuse to your file, and the request can be processed as if it never arrived.
Mark the medical-excuse checkbox or section clearly. Some forms ask you to briefly describe the reason in your own words before attaching the letter. Keep it simple and consistent with what your provider wrote. If the form includes a declaration that you’re signing under penalty of perjury, read it carefully before signing. That is a legal statement, not a formality.
Submit however the summons tells you to: mail, fax, email, or the online eJuror system used by many federal courts.2United States Courts. Summoned for Federal Jury Service? The deadline matters more than anything else. Many federal courts require the completed package within five business days of receiving the summons. State deadlines vary and are printed on the summons itself. If you mail documents, send them early enough to arrive before the deadline, not just postmarked by it. Missing by a day usually means your request is denied and you are expected to appear.
Keep copies of everything, including the letter, the form, and any confirmation number or tracking receipt.
If the Court Denies Your Request
Not every medical excuse is granted. If the court decides your documentation is insufficient or your condition doesn’t rise to the level of excusal, you’ll be expected to appear on your reporting date. Some courts notify you only when a request is denied and treat silence as approval; others confirm every decision in writing. Check your summons for how your court handles notifications.
A denial isn’t the end of it. You can submit additional documentation from your provider that more specifically addresses why you cannot serve. You can also explain your situation to the judge in person on your reporting date. Judges have broad discretion to excuse jurors, and an in-person explanation sometimes succeeds where paperwork didn’t. Bring your doctor’s letter with you even if you already submitted it, because the judge may not have your file immediately in hand.
What you should not do is simply stay home. The court treats your summons as a legal order.
Penalties for Skipping or Faking
Skipping jury duty without an approved excuse is not a minor issue. In the federal system, anyone who fails to appear after being summoned and cannot show good cause can be fined up to $1,000, jailed for up to three days, ordered to perform community service, or hit with a combination of all three.3Office of the Law Revision Counsel. 28 USC 1866 – Selection and Summoning of Jury Panels State penalties vary but follow a similar pattern, including fines and possible contempt charges.
Submitting a fraudulent letter is far worse. A fake note or a forged signature is a false statement to a court, and knowingly making a false statement in a matter within federal jurisdiction carries a penalty of up to five years in prison.4Office of the Law Revision Counsel. 18 USC 1001 – Statements or Entries Generally If your condition is genuine, getting the paperwork right is straightforward. If it isn’t, the risk is wildly out of proportion to a few days of service.