BOOKING

Full names of each party to the mediation and their full contact details;

Party One
Full Name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Phone*
Lawyer’s Details*
Party Two
Full Name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Phone*
Lawyer’s Details*
Other Information Required
Payment of mediation fees
- Shared Equally
- Party One
- Party Two
Preferred Mediation Venue
Issue to be discussed
- Property
- Parenting
- Both
Preferred Date for Mediation:*
Date Format: MM slash DD slash YYYY
Booking made by:*
Contact Number*
Email*
Any other related details

Booking