| Number of party expected to attend
mediation
|
| 1. |
Mediation referral to Gilbert Mediation Group
initiated by:
Email Address:
|
| 2. |
Type of case:
|
| 3. |
Names, addresses, and telephone numbers of
Plaintiff parties
(identify authorized representatives,
if known) and attorneys of record:
|
| 4. |
Names, addresses, and telephone numbers of
Defendant parties
(authorized representatives,
if known) and attorneys of record:
|
| 5. |
Names, addresses, and telephone numbers of
other parties
(please specify, "Intervener",
etc and identify authorized representatives,
if known) and attorneys of record:
|
| 6. |
The nature of Plaintiff's claims and the Defendant's
defenses and counterclaims:
|
| 7. |
What relief is sought by parties:
|
| 8. |
What are the primary disputed issues of law
or fact in this case from your perspective:
|
| 9. |
What is the status of discovery:
|
| 10. |
Do you have sufficient information to form
a realistic settlement position?
If not, what else is needed?
|
| 11. |
What are the last offers of the parties?
|
| 12. |
ON BEHALF OF
, ONE OF THE PARTIES IN THE ABOVE
CAUSE, THE UNDERSIGNED ATTORNEY OF RECORD REQUESTS
THAT GILBERT MEDIATION GROUP ACT AS MEDIATOR
IN THE ABOVE CASE; AND WE AGREE TO BE BOUND BY
THE RULES OF MEDIATION AND MEDIATION FEE CRITERIA
PROVIDED BY THE MEDIATOR TO ME. |
| 13. |
DATED:
(Use
this format: "January 1, 2006") |
| |
|
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