Schedule Mediation

REQUEST TO SCHEDULE MEDIATION:

* Indicates required field

Case Number and County *

Party One Name *

First

Last

Party One Email *

Party One Phone Number *

Fee Waiver (if applicable) *

Max file size: 20MB

Party One Attorney *

First

Last

Party One Attorney Email *

Party One Attorney Phone Number *

Party Two Name *

First

Last

Party Two Email *

Party Two Phone Number *

Fee Waiver (if applicable) *

Max file size: 20MB

Party Two Attorney *

First

Last

Party Two Attorney Email *

Party Two Attorney Phone Number *

Dates / Times when ALL parties and attorneys are available (see http://www.glynnabaker.com/calendar.html for mediator's availability)

First Choice Date and Time *

Second Choice Date and Time *

Third Choice Date and Time *

Comments (protection orders, special instructions, etc.) *

Submit