If a patient requests to be excused from jury service for reasons related to mental or physical conditions, Arizona law requires a written statement from a physician, physician assistant, or registered nurse practitioner (“RNP”) licensed by the state of Arizona. If a prospective juror does not have a physician, physician assistant, or RNP, a professional caregiver may complete this form. The professional caregiver must be deemed acceptable by the court or jury commissioner for this purpose.

Some mental and physical problems do not warrant an excuse from service but may warrant a postponement. For any excuse that you provide, please be aware that you may be called to testify before the court about your representations regarding your patient’s inability to perform jury service. ALL questions must be answered legibly. If not, this application will be considered incomplete and invalid.

Download the Medical Excuse Form

Arizona State Board of Nursing - Nursing Regulatory Journal
Thursday, October 13, 2016
Working Together to Promote NCSBN Nursys e-Notify
Working Together to Promote NCSBN Nursys e-Notify Want to learn more about how NCSBN can help you promote NCSBN Nursys e-Notify in your jurisdiction? ...
Tuesday, October 04, 2016
NCSBN Makes Substance Use Disorder Educational Courses Free to Nurses and Nursing Students
The National Council of State Boards of Nursing NCSBN Board of Directors has voted to provide NCSBN courses “Understanding Substance Use Disorder in N...
Wednesday, June 22, 2016
Fingerprint Card Policy Change
Our fingerprint card policy has recently changed. If you have not received a fingerprint card from the Arizona State Board of Nursing you may go to an...
Tuesday, June 21, 2016
Consent Agreement and Order Training - Thursday, August 31, 2016
For people who have signed an agreement or who are considering signing an agreement with the Board of Nursing, please attend a Consent Agreement/Order...

DISCLOSURE STATEMENT

Statement of locations where all notices of the meetings of the Arizona State Board of Nursing will be posted.

Pursuant to A.R.S. §38-431.02(A)(1)(a), the Arizona State Board of Nursing will post all notices of the meetings of the Arizona State Board of Nursing Meetings and any of its committees and subcommittees on the Board's website at www.azbn.gov. Notices will indicate the date, time, and place of the meeting and will include an agenda or information concerning the manner in which the public may obtain an agenda for the meeting.

Top