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It is our policy to help in every way possible, not only to resolve disputes, but to assist the attorneys and their clients as much as possible. Our staff will take up the task of scheduling the mediation between the various attorneys. We simply need the name and number of the case, the names of the attorneys, and who they represent, their phone numbers, addresses, and fax numbers. Upon receiving this information, our staff will schedule the mediation between all attorneys at no additional charge.

A mediation is not booked until confirmed by our office. If you do not hear from our office within 24 hours of sending this form, please contact us by telephone.

Please submit the information requested below so that we may
contact you and confirm a mediation.

Name:

Assistant's Name:

Firm/Company:

Phone Number:                     Fax Number:
      
Email Address:

Dates of Interest:	Full Day/Half Day:	# of Parties:

Nature of Case:


Case Number:

Style of Case:

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