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Mediation Forms

Below are several forms that will be used for mediation.  Please try to review these forms prior to mediation.  I will have sent you some information via email to let you know if any of these forms will need to be printed (that is unlikely).  If you have questions about these forms, please don't hesitate to contact me.

Agreement to Mediate

This form explains mediation, confidentiality, and some legal information regarding mediation.  I will review this form with you when we are the call together and then most likely, email something to you via DocuSign in order to get your signature.  Click the button below to review the document before or at the beginning of the session.

Family Mediation Topics

This form provides information about topics that are sometimes covered in mediation.  I offer this document in hopes that discussion and/or agreements can meet the needs of parties for the foreseeable future.  Review this document as it may prompt an "oh yeah" moment that leads to a fuller discussion during mediation.


This is a calendar that I use in mediation that you are welcome to use any way that is helpful.  

Demographic Survey

This form is used to collect demographic information which helps keep mediation FREE to court referred parties.  Your name is not included when this information is sent and this information in NO way, affects your case.  That form can be viewed using the black button and completed electronically using the GREEN BUTTON (preferred)

Evaluation of Mediation and Mediators

The courts like to be sure that the mediation services being provided are of the highest quality.  For each mediation session, they ask that the parties complete an evaluation. That form can be viewed using the black button and completed electronically using the GREEN BUTTON (preferred)

CoParenting Class Evaluation

This form helps to evaluation the Two Parents, Two Homes seminar.  You honest feedback is greatly appreciated.  Once you have completed the evaluations, your certificate will be sent to you.  

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