If you are not represented by legal counsel, please share your full name and if applicable, the name of your company. If you are legal counsel representing a client/party, please share the full name of each client and related business you represent in this matter. Please also share all client contact information including address, phone and email. We will use this information for a conflict of interest check.

If you are an attorney representing the above party in this case, please include your full name, the name of your firm, and all your contact information including address, email and telephone number. If you are not represented by counsel, please answer N/A for not applicable.

Who is the other party or parties? Please share full names and the names of all related companies. Please also share all contact information you have regarding all other parties including address, phone and email. We will use this information for a conflict of interest check.

If the other party or parties is represented by legal counsel, please share the name, the name of the firm, and all other contact information you have about all other counsel, including address, email and telephone number. Please answer N/A if this is question isn't applicable.

Please share a brief overview of the dispute. What are the primary issues? The purpose of this question is to simply make sure the dispute involves a topic we are able to assist you with. This is not the place to present an argument as to your side of the dispute. Simply share one or two sentences describing the underlying issue.

Please note that if we are eventually retained to serve as a mediator in this matter, you will receive instructions for submitting, at your option, a mediation brief along with all supporting evidence you'd like us to review. For now, simply share a short one or two sentence objective description of the dispute. Please note that all information is private and will not be disclosed to the other side.

What is your mediation time frame? What dates/months would you like to schedule your mediation? (list all available times/dates or blocks of days/months that work for your calendar). If you've already cleared available dates that work for all other parties, please indicate below. Out goal is to make the scheduling of your mediation as easy and convenient as possible. 

Please share any comments or questions you have. Otherwise, we will review your responses to this form, along with the responses of all other parties or counsel, and reach out with the next steps regarding scheduling a mediation date.