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Referral Partner Intake
Housing partners who are referring a client to mediation can fill out this intake form. CMM will then contact the client to discuss scheduling a FREE mediation. CMM works with both Property Owners/Property Managers & Renters.
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What is your name and your organization's name?
Your answer
What is your client's first and last name?
Your answer
Is your client a:
Property Owner/Manager
Renter
Homeowner
Clear selection
What is your client's preferred method for contact:
Email
Phone
What is your client's email and/or phone number?
Your answer
Does your client have a date to appear in housing court? If so, please include the date below.
Your answer
Are you willing to participate in the mediation if requested?
Yes
No
Clear selection
What county does your client reside in? Please respond "unknown" if that applies.
Your answer
Please provide a brief description of the reason for this referral.
Your answer
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