When writing a jury excuse letter, directly state why you cannot serve and how serving would lead to hardship. If you are not selected as a juror your service will conclude at the end of jury selection.There are no automatic exemptions or excuses from jury service in New York State. Were you selected for possible jury service and looking to fill out your juror qualification questionnaire online? We provide the eResponse Online Jury Services system for individuals who have received a Jury Summons. To request a medical disqualification, please fill out Part I of this form and have a licensed health care provider complete. Part II of this form. You may claim an exemption from jury service if one of the following pertains to you: Are over 75 years of age. Answer all questions, sign, date and return this form in the enclosed envelope or complete the form online within ten days. Complete the juror qualification questionnaire before submitting a request to be excused.