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Washington State Jury Commission

Appendix 8: Sample Exit Questionnaire

(For Recommendation 43)

JURY SERVICE EXIT QUESTIONNAIRE
(adapted from a questionnaire used by the Ninth Circuit)

Your answers to the following questions will help improve jury service. All responses are voluntary and confidential. (Please circle answers where appropriate.)

1. Approximately how many days did you report to the courthouse?	_______________
2. What percent of your time was spent in the jury waiting room?	_______________
3. How many times did you report to a courtroom for jury selection?	_______________
4. How many times were you actually selected to be a juror?	_______________
5. How would you rate each of the following factors?

Good

Adequate

Poor

A. Initial Orientation

B. Treatment by Court Personnel

C. Physical Comforts

D. Personal Safety

E. Parking Facilities

F. Scheduling of Your Time

6. After having served, what is your impression of jury service? (Circle one)

A. The same as before - Favorable

B. The same as before - Unfavorable

C. More Favorable than Before

D. Less Favorable than Before

7. AGE: 18-20 21-24 25-34 35-44 45-54 55 -64 65-Over

8. SEX: Female Male

9. OCCUPATION: ____________________________________________________________

10. RACE: Black White Other

11. Did you lose income as a result of jury service?	YES	NO

Amount $ __________________

12. Have you ever served on jury duty before?	YES	NO

13. (a) Are you a registered voter in the county?	YES	NO
(b) Do you have a driver's license and/or identification card issued by the Department of Licensing?	YES	NO

14. In what ways do you think jury service can be improved? (Use reverse side if necessary)

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