Get the free Peer Mediation Referral - Haddonfield Public Schools - haddonfield k12 nj

Peer Mediation Request Form Date Names of students involved in the conflict: Name Teacher/Grade Name Teacher/Grade Name Teacher/Grade Where did the conflict occur: (circle all that apply) Classroom

How to fill out peer mediation referral

How to fill out a peer mediation referral:

1. Start by obtaining a copy of the peer mediation referral form from your school or organization. This form may be available online or from a designated office.
2. Fill in the requested personal information, such as your name, contact details, and any identification numbers or student IDs required.
3. Provide the names of the parties involved in the conflict or dispute. Include any relevant details such as their grade level, class, or relationship to you.
4. Clearly describe the issue or conflict that necessitates peer mediation. Be specific about the incident or problem, providing relevant dates, times, and locations if applicable.
5. Include any supporting information or evidence that may assist the peer mediators in understanding the situation. This can include written statements, witness accounts, or any documented incidents related to the conflict.
6. Indicate your preferred language for the mediation process. If there are any language considerations or requirements, mention them to ensure proper communication during the mediation session.
7. Check if there are any additional fields or sections on the form that require completion, such as consent for sharing information or specific requests for mediation.
8. Review the completed form for accuracy and legibility. Make any necessary corrections or clarifications before submitting it.

Who needs peer mediation referral:

1. Students who are experiencing a conflict or dispute with another individual or group may benefit from a peer mediation referral. This could include conflicts between friends, classmates, teammates, or even within a club or organization.
2. Teachers, administrators, or counselors who observe or become aware of a conflict involving students may also initiate a peer mediation referral. They can facilitate the process by referring the students to the appropriate mediation program or office.
3. Peer mediation referrals can be used for conflicts of varying degrees, from minor disagreements to more significant issues. The purpose of the referral is to provide an opportunity for the parties involved to resolve their dispute through facilitated discussions with trained mediators.

Overall, anyone who believes that peer mediation may help in resolving a conflict should consider initiating a peer mediation referral.

For pdfFiller’s FAQs

What is peer mediation referral?

Peer mediation referral is a process where conflicts between individuals are resolved with the help of trained mediators who are peers of the individuals involved.

Who is required to file peer mediation referral?

Anyone involved in a conflict where both parties agree to participate in peer mediation can file a referral.

How to fill out peer mediation referral?

To fill out a peer mediation referral, you will need to provide information about the conflict, the individuals involved, and contact information for all parties.

What is the purpose of peer mediation referral?

The purpose of peer mediation referral is to facilitate communication and problem-solving between individuals in conflict, in a neutral and supportive environment.

What information must be reported on peer mediation referral?

Information such as the nature of the conflict, the individuals involved, and any previous attempts to resolve the conflict should be reported on a peer mediation referral.

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