Jury Duty Exemption Letter

Do you require a letter to exempt you from Jury Duty?
THIS IS NOT FOR PATIENTS WHO HAVE BEEN CALLED AS WITNESS.
Complete the form below which will be given to your GP. - By sending in this form you are agreeing to receive email and/or sms communications from us. We will only use this information to communicate with you about Penicuik Medical Practice and the service we provide.

Patient Details

Personal details belonging to the patient

Name *

Date of Birth *

Address: *

Contact number: *

Email address: *

Jury Duty Details

Details of your Jury duty attendance.
THIS IS NOT FOR PATIENTS WHO HAVE BEEN CALLED AS A WITNESS

Citation Number *

Court Date *

REASON FOR EXEMPTION *

Personal ID Number *

We email the exemption letter, as this is the preferred option by the jury service. Please indicate below if another approach is needed *

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Page last reviewed: 28 May 2026
Page created: 01 July 2019

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Jury Duty Exemption Letter

Jury Duty Exemption Letter

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