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Mediation Intake Form

Ready to schedule mediation?

Complete our quick and secure online intake form.

Your personal information is kept strictly confidential and will never be shared with outside agencies or other parties. Any demographic information collected is used solely for statistical purposes. The form takes approximately 10–15 minutes to complete.

Please answer as many questions as you can to the best of your ability.
If possible, encourage the other party to complete the form as well—this helps us get started more quickly.

Important:
We require the name and contact information for each party in order to move forward.
We aim to respond within two business days. Please note that it may take up to 9 weeks to schedule your mediation.

Thank you for your patience and commitment to resolving your dispute.