LACMA Jury Duty Concierge: Request Submission Form
BEFORE PROCEEDING: YOU MUST REGISTER FOR JURY DUTY SERVICE AS WRITTEN ON YOUR SUMMONS BEFORE YOU CAN SUBMIT YOUR REQUEST TO UTILIZE LACMA'S JURY DUTY SERVICE. Once that is completed, please complete the following fields to process your Jury Duty request.
Name *
Your answer
Physician E-mail *
Your answer
Physician Cell Phone *
In case of changes on the day of your service, we will send you an SMS update.
Your answer
Physician Alt. Phone
Your answer
Office Manager Name
Your answer
Office Manager E-mail
Your answer
Office Manager Phone
Your answer
Practice Name *
Please name Practice, Hospital, etc.
Your answer
Practice Mode *
Please check all that apply
Required
Type of Court Notice *
Please select which type of notice you have received
Required
Juror ID Number *
Please enter your 9-digit number, as written on your Jury Summons
Your answer
Pin # *
Please enter your 4-digit number, as written on your Jury Summons
Your answer
Current Date of Jury Summons *
MM
/
DD
/
YYYY
Current Court Location *
Please select court location as listed on your Jury Duty Summons
Requested Postponement Date *
Please select the first date of the week of your requested postponement. Please select the day of the week that is most convenient for you to report, if called for service (MTWThF)
MM
/
DD
/
YYYY
Preferred Court Location *
Please select new court location. If you do not wish to change your court location, please select court location listed on Summons
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