The Connecticut Request for Medical Disqualification from Jury Service is an application to the court in order to be excused from jury duty due to a medical condition. It is available as a form for a prospective juror to fill out in order to prove to the court that they are unable to serve as a juror. This form must be completed and signed by a physician. It must also include a detailed medical diagnosis and prognosis, and any other information relevant to the medical condition that renders the prospective juror unable to serve on a jury. There are two types of Connecticut Request for Medical Disqualification from Jury Service: Permanent and Temporary. A Permanent Medical Disqualification is a permanent exemption from jury service due to a medical condition that is not expected to improve. A Temporary Medical Disqualification is for a period of time due to a medical condition that is expected to improve. In either case, the physician must provide information detailing the medical condition and prognosis.