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JUROR DAILY HEALTH QUESTIONNAIRE

Please mark with a “Yes” any symptoms that are new for you today.





























You are expected to maintain good hand hygiene practices, physical distancing of 6’ or more when possible and wear a mask.Masks must cover your mouth and nose at all times. 

If you feel ill before or during your service, have been in close contact with or live with someone who tests positive for COVDID19 please contact Jury Services at 608-931-2364.


If you test positive for COVID-19 during your jury duty, you are asked to notify Jury Services at 608-931-2364.


CDC information on COVID-19:  https://www.cdc.gov/coronavirus/2019-ncov/index.html

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