Your Name
Your Firm Name
Your Reference
Your Address
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DX
Telephone
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Client Name
Address
We are happy to contact your client direct. If the mediation proceeds, we will confirm the appointment details with you. It would be helpful if you could provide us with the other party’s details below. Unless you specifically tell us otherwise, we will also contact them.
Name
Preferred location for mediation
Emsworth Fareham Havant
Issues for mediation:
Children Property & Finance Divorce/Separation All issues Consultation with children
Is your client already in receipt of legal help:
Yes No
Is this a referral for a Mediation Information and Assessment Meeting?
Are there proceedings or injunctions?
It is crucial that we are told about safety or other issues, such as domestic violence before clients attend the initial meeting. Do either of the clients have any concerns about:
Mental Health
Domestic Violence
Child Protection
Any special facilities required? If so please specify:
How did you hear about Mediation Now?
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