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As part of the court’s ongoing measures to protect against the spread of the COVID-19 disease, we ask that you complete the following before your date of service.

* Denotes a required field

* Full name In format first, middle, last
* Contact History: Check any that apply to you or a member of your household If the below apply to you, call the District Clerk's office at 409-267-2432 before reporting on your date of service.

* Prospective jurors are strongly encouraged, but not required, to wear a face covering while they are in a county building. Individuals are encouraged to bring a cloth face covering with them. If an individual does not have a cloth face covering, a disposable face mask will be provided upon request. Your temperature will be taken at the door. Individuals whose temperature equals or exceeds 100.0ºF will be refused admittance to the court building. I certify the above is true and correct (please enter name):

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