Request for Virtual Domestic Mediation
This form is for attorneys ONLY. Basic information to schedule your Family Law case for a virtual mediation.
Email address *
Name of person submitting request *
Best contact number of person submitting request in case we have scheduling questions *
Civil Action Number or Pre-filing (PF) *
Who is requesting mediation, Plaintiff or Defendant or agreed to by both? *
Do you have a mediator preference? *
Type of Case *
Dates both parties are available for mediation: Please provide up to 3 dates. *
Virtual Mediation will start at 10:00 unless otherwise requested. If you have a preferred start time, *
Next
Never submit passwords through Google Forms.
This form was created inside of Mediation Center of the Coastal Empire. Report Abuse