Jury questionnaire

In some jurisdictions, a short jury questionnaire is sent out to prospective jurors with the request that they answer the questions and return the form to the court. Usually the form is short and demographic in nature. Name, address, age, employment, and education are the questions commonly asked in court-generated questionnaires. That information is better than nothing, but such questionnaires usually leave out questions on relevant attitudes.

Experienced personal injury lawyers will often create a juror questionnaire and use it as a tool in trial strategy. Even if the judge allows a lawyer to conduct oral voir dire, there are many advantages of using a juror questionnaire: A written questionnaire ensures that the lawyer receives the same information and more in-depth information about each juror in the entire pool. It also helps flush out information from jurors who are reluctant to talk in open court and draws out more honest responses. A written questionnaire also minimizes the risk of contamination from one juror convincing others of a position opposite from the lawyer’s interests.

Lawyers receive much more information if they combine oral voir dire with a written questionnaire. Show-of-hands questions don’t reveal as much about these future decision makers. A written questionnaire is more likely to produce real information that can be used in making choices about the depth of feeling of a potential juror.

If a court does not already use its own questionnaire, most judges at least will consider using a juror questionnaire if it is proposed to them. Judges are especially likely to consider use of juror questionnaires in long cases, in complex or multiple part cases, and in cases involving sensitive issues. An experienced trial lawyer will attempt to convince the court that a questionnaire will both save time and produce a better jury.

The following questionnaire is a form of jury questionnaire for a bodily injury case.

Jury Questionnaire, Bodily Injury Cases

Confidential Questionnaire

Juror No.: ___________

  1. Name: _________________________________ Age: ___________
  2. Please list your last three jobs, including the employer, the positions and duties held, and the length of time on each:
  3. How long have you been employed in your last job?

    If unemployed/retired, how long ago did you leave your employment or retire?

  4. Have you, any family members or friends ever worked for, or done business with, [name of companies involved in this case]?
    Yes
    No

    If yes, briefly describe.

  5. Have you ever had a job that required you to drive long distances?
    Yes
    No

    If yes, briefly describe.

  6. Have you ever held a job that required you to see that safety regulations were followed?
    Yes
    No

    If yes, what kind of job was it, and how were safety regulations involved?

  7. What is your current marital status?
    If married, for how long?
    Have you ever been divorced?
  8. What is the occupation of your spouse/partner?
    If unemployed/retired, what was this person’s last job?
    What jobs has this person held in the past?
  9. Your parent(s) employment (if deceased or retired, list principal employment when working):
  10. List your children’s employment or schools, if applicable:
  11. What was the highest educational level completed by:
    Juror Spouse Children Father Mother
    Grammar School          
    High School          
    Some College          
    College Degree          
    Post-Graduate Degree          
  12. If you had some college or graduated from college, what was your major and degree, if any?
  13. Have you ever served in the Armed Forces?
    Yes
    No

    Years Served:
    Rank:
    Branch:

  14. Have you attended any training, education, lectures, seminars or courses in any of the following areas? Check all those that apply:
    Accounting
    Business
    Home Safety
    Rehabilitation
    Traffic Accidents
    Business Law
    Insurance
    Therapy
    Physical Therapy
    Chemistry
    Law
    Insurance Statistics
    Engineering
    Medicine
    Finance
    Automobile Safety
    Psychology
    Brain Injuries
    Work Safety
    None of the above
  15. Have you, any family members or friends ever applied for work with, worked for, done business with, or owned stock in any insurance company?
    Yes
    No

    If yes, who, for what company(ies) and what was the relationship to the company?

  16. Have you or any family members held a job that involved writing or reviewing claims?
    Yes
    No

    If yes, please explain:

  17. Which of the following types of insurance do you have? Check all those that apply:
    Auto Life Business Health Home/Apartment Other
  18. Have you ever had any type of insurance policy with ABC Insurance Company?
    Yes
    No

    If yes, what type of insurance policy do/did you have with ABC?

  19. In general, what are your opinions or feelings about insurance companies?
  20. Have you or any family members ever made a claim on an insurance policy?
    Yes
    No

    If yes, please explain:

  21. Have you or any family members ever owned a business?
    Yes
    No

    If yes, what type of business, where and when?
    If the business is no longer open, why was it sold or closed?

  22. Have you or anyone in your family ever hired attorneys, or worked for any attorneys or law firms?
    Yes
    No

    If yes, and if they were in this state, which attorneys or law firms?

  23. Do you know any attorneys on a personal basis?
    Yes
    No

    If yes, who do you know and how do you know this person?

  24. Have you or anyone you know ever worked as a firefighter, paramedic or emergency medical technician?
    Yes
    No

    If yes, please explain:

  25. Have you or any family members ever applied for work at any hospital, medical clinic, rehabilitation clinic, doctor’s office, or other medical facility?
    Yes
    No

    If yes, please explain:

  26. Have you, any family members or close friends ever been a Plaintiff (the person suing) or a Defendant (the person being sued) in a lawsuit?
    Yes
    No

    If yes, please explain:

  27. How many times have you served as a juror in a:

    Criminal case _____ times Civil case ____ times Never Served

    Were you the foreperson?

    Yes
    No
  28. Have you or anyone you know ever been seriously injured while in another person’s home or motor vehicle?
    Yes
    No

    If yes:

    Who was injured?
    What was the injury?
    What caused the injury?
    Was there a lawsuit(s) filed because of the injury?

    Yes
    No

    What was the outcome of the lawsuit?
    How did you feel about the outcome of the lawsuit?

  29. Have you ever known anyone who was seriously injured but whose injuries were not visible or apparent?
    Yes
    No

    If yes, please tell us about that situation:

  30. Have you ever had the responsibility of taking care of a family member or friend who was seriously injured?
    Yes
    No
  31. Which of the following would you use to describe yourself? Check all those that apply:
    Analytical
    Assertive
    Athletic
    Careful
    Cautious
    Compassionate
    Compulsive
    Creative
    Decisive
    Detailed
    Determined
    Emotional
    Frugal
    Generous
    Impulsive
    Judgmental
    Leader
    Logical
    Naïve
    Not Talkative
    Old-Fashioned
    Open-Minded
    Opinionated
    Outspoken
    Practical
    Private
    Pro-Company
    Pro-Worker
    Quiet
    Religious
    Selfish
    Sensitive
    Shy
    Skeptical
    Smart
    Snap-Decision
    Strict
    Successful
    Team Member
    Technical
    Thoughtful
    Thrifty
    Trusting
    Visual
    Worrier
  32. Please list any unions or civic, social, professional, or religious organizations to which you now belong or have belonged:
  33. In a case where a person slipped and fell at a grocery store because someone did not do his/her job of wiping up water, do you think the person should try to get money for his/her injuries?
    Yes
    No

    If yes, please explain:

  34. How do you feel about the amount of money damages awarded in lawsuits today? (Please check your response:)
    Much Too High
    Somewhat High
    About Right
    Somewhat Low
    Much Too Low
  35. Are you or anyone in your family a member of CALA (Citizens Against Lawsuit Abuse) or any other group that wants to change laws about lawsuits?
    Yes
    No

    If yes, tell us which groups:

  36. Please list the newspapers, magazines, professional journals, or periodicals which you regularly read:
  37. How many hours a week do you spend watching television?
  38. List your three favorite TV programs:
  39. Name two or three people you admire or that most influenced your life, and why.
  40. Please list the one person you admire least, and why:
  41. Have you or anyone in your family lost sexual ability for a period of time?
    Yes
    No

    If yes, how affected are you today by what happened in the past?

  42. What do you enjoy doing in your spare time?
  43. What do you think about the number of lawsuits filed in recent years? Please check your response:
    Much Too High
    Somewhat High
    About Right
    Somewhat Low
    Much Too Low
  44. Who makes the financial decisions in your home?
  45. Are you:
    Very Conservative
    Conservative
    Moderate
    Liberal
    Very Liberal
  46. Have you ever had the responsibility of taking care of anyone who was seriously ill or injured?
    Yes
    No

    If yes, please briefly explain.

  47. How often do you wear a seatbelt in a car?
    Always
    Usually
    Rarely
    Never
  48. Can you think of an example when an honest mistake has been described as negligence?
    Yes
    No

    If yes, please briefly explain.

  49. Have you ever had an injury, property loss or financial loss as a result of someone’s negligence or wrongful conduct?
    Yes
    No

    If yes, please briefly explain.

  50. In our country, when a person has been injured because of the negligence of someone else, in most instances, money is the only form of compensation that a person can seek under our system of justice. Do you think that is a good system? Why or why not?
    Yes
    No

    If yes, please briefly explain.

FREE case EVALUATION