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PSD Mediation Services REFERRAL FORM Date: Referring person s name (not required): Student referred Gender Grade Relationship of Parties Age Type of Dispute Friends Physical Fight Boyfriend/girlfriend
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How to fill out mediation referral form
How to fill out a mediation referral form:
01
Obtain the mediation referral form from the appropriate source, such as your attorney, court, or mediation service provider.
02
Begin by filling out your personal information, including your name, address, phone number, and email address.
03
Provide the details of the other party involved in the dispute, including their name, address, and contact information.
04
Clearly state the reason for seeking mediation and the nature of the dispute. Provide a brief description of the issues or conflicts involved.
05
Indicate whether you have already attempted any other methods of resolving the dispute and provide any relevant information about those attempts.
06
Mention if you have any specific preferences regarding the mediator or the date/time of the mediation session.
07
Sign and date the form, acknowledging that the information provided is accurate to the best of your knowledge.
08
Keep a copy of the completed mediation referral form for your records.
09
Submit the form according to the instructions provided, whether it is by mailing it, delivering it in person, or submitting it electronically.
Who needs a mediation referral form:
01
Individuals involved in a legal or personal dispute that they wish to resolve through mediation rather than going to court.
02
Parties who have attempted other methods of resolving the conflict but have been unsuccessful or are seeking an alternative approach.
03
Anyone who wants to have a neutral third-party mediator facilitate discussions and negotiations between the parties to help reach a mutually acceptable agreement.
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What is mediation referral form?
Mediation referral form is a document used to refer parties to mediation in order to resolve disputes outside of court.
Who is required to file mediation referral form?
The parties involved in a dispute are required to file the mediation referral form.
How to fill out mediation referral form?
The mediation referral form can be filled out by providing information about the parties involved, the nature of the dispute, and any other relevant details.
What is the purpose of mediation referral form?
The purpose of mediation referral form is to initiate the mediation process and facilitate the resolution of disputes through mediation.
What information must be reported on mediation referral form?
The mediation referral form must include information about the parties involved, the nature of the dispute, and any relevant details.
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