Mediation Sign-Up
Please provide us with the following information so that we assign you a mediator as promptly as possible.
Email address *
Your Name
Your answer
Your Mailing Address
Your answer
Your Phone Number
Your answer
Please describe the days and times you can be available for mediation.
Your answer
Name and contact info for other parties. (Please include at least an email or phone number for each of them.)
Your answer
Please write a brief description of the conflict you wish for us to mediate.
Your answer
My conflict involves:
(All fees can be administered on a sliding scale. We do not turn away clients for inability to pay.)
Do you require financial assistance with our fees?
If so, a staff member will be in touch to discuss payment arrangements. Do not let finances keep you from the possibilities of conflict resolution!
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