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Jury Service COVID-19 Pre-Screening Questionnaire

  1. Jury Service COVID-19 Pre-Screening Questionnaire

    As part of the court's ongoing measures to protect against the spread of COVID-19, please complete the following before reporting for Jury Service.

  2. 1. Symptoms now or 10 days before the date of Jury Service:*

    Check any that apply to you or a member of your household

  3. If you are experiencing any of the above symptoms, call Abilene Municipal Court at (325) 676-6333 before reporting to Jury Service.

  4. 2. Contact History*

    Check any that apply to you or a member of your household

  5. If any of the above apply, call Abilene Municipal Court at (325) 676-6333 before reporting to Jury Service.

  6. 3. COVID-19 Related Excuse or Postponement

    Individuals who are over age 65 and individuals with serious underlying health conditions, such as high blood pressure, chronic lung disease, diabetes, obesity, asthma, and those whose immune systems are compromised, such as by chemotherapy for cancer or other conditions requiring such therapy, are considered to be vulnerable populations and may request to postpone or be excused from jury service at this time. If you wish to be excused or request that your jury service be postponed, check the box below.

  7. If you are requesting to be excused or your service date be postponed due to a COVID-19 related reason, call Abilene Municipal Court at (325) 676-6333 before reporting to Jury Service.

  8. 4. Face Coverings

    Prospective jurors are encouraged but not required to wear a face covering while they are in the courthouse. Individuals are encouraged to bring a cloth face covering with them.

    I certify the above is true and correct:

  9. Leave This Blank:

  10. This field is not part of the form submission.