IN THE CIRCUIT COURT OF THE 22ND JUDICIAL CIRCUIT McHENRY COUNTY, ILLINOIS IN RE THE MARRIAGE OF: ______________________________________ Petitioner, vs. ______________________________________ Respondent. ) ) ) ) ) ) ) ) ) Case Number __________________________ MEDIATION ORDER This matter coming before this Court on the issue of mediation and the Court being full advised in the premises, FINDS: That one or more of the issues of parental responsibility allocation and parenting time, or access to children are present and in dispute between the parties, that at this time this action is not otherwise determined to be ineligible for mediation, and as authorized by Illinois law and pursuant to local rule 18.03, and Illinois Supreme Court Rule 905: IT IS THEREFORE ORDERED THAT: 1. The parties hereto shall participate in the mediation process and this Court hereby appoints as mediator: Name: _____________________________________________________________________________________ Address: ____________________________________________________________________________________ Telephone: ______________________________________ Fax: _______________________________________ 2. The following are the required issues for discussion in mediation (check all that apply): Initial Parental Responsibility Allocation and Parenting Time Modification of Parental Responsibility Allocation and Parenting Time Removal Other Non-Economic Issues Relating to the Children Economic Issues Other issues may be mediated upon agreement of the parties and their attorneys. 3. The Mediator's Interim (or Final) Report should be submitted by the first Status of Mediation Court date, set for __________________________________ at ____________ a.m. The Mediator's Report shall be submitted to the Court and to the parties' attorneys prior to said date and prior to any subsequent Mediation status dates. 4. Both attorneys or any self-represented litigant party shall immediately forward a copy of this Order to the appointed mediator. 5. Each party shall register for the Court approved parenting program through McHenry County College at (815) 4797591, within seven (7) days of this Order. The parties shall report the status as to completion of this program at the Status of Mediation court date, set for __________________________________ at ____________ a.m. 6. Each party shall contact the appointed mediator within seen (7) days of this Order to schedule mediation. Each party is directed to be fully cooperative in scheduling mediation. Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 7. The Mediator shall inform the parties of their rights and obligation at the initial mediation session per Family Division Mediation Program Rules, Part 18.00 et seq. 8. The parties shall pay, no later than the first scheduled mediation session, as a retainer, a sum equal to five (5) hours of the appointed mediator's usual and customary hourly rate. The Mediator shall be compensated by the parties at the rate agreed to by the parties and the mediator, or as set by the Court. Petitioner shall pay _____% and Respondent shall pay _____% of the Mediator's fee, including a retainer, without prejudice to reallocation by the Court. 9. Unless otherwise ordered, or at the specific request of the Mediator, neither party, nor counsel for either party, or any person acting on behalf of either party, shall send pleadings, correspondence, or other written materials to the appointed mediator. 10. Mediation ordered hereunder is subject to the terms and conditions of the 22nd Judicial Circuit Court Rules for McHenry County, Family Division Mediation Program Rules, Part 18.00 et seq. 11. Neither party shall discuss the details of mediation sessions with their minor child or children. 12. Only written discovery on issues not being mediated shall be allowed until receipt of the appointed mediator's final report or termination of mediation, except by Order of the Court. 13. The parties represent to the Court as follows (at least one box must be check): No Orders of Protection have ever been entered involving the parties to this case; or The parties are or have been in the past (check at least one) involved in a proceeding under the Illinois Domestic Violence Act (IDVA); or A current Order of Protection prohibits one of the parties from having any contact with the other party. COURT DATE: ______________________________ TIME: _____________________ ROOM: __________________ Petitioner: ___________________________________________________ Telephone: ___________________________ Address: __________________________________________________________________________________________ Fax: ________________________________________ Email: ________________________________________________ Attorney for Petitioner: ________________________________________ Telephone: ___________________________ Address: __________________________________________________________________________________________ Fax: ________________________________________ Email: ________________________________________________ Respondent: __________________________________________________ Telephone: ___________________________ Address: __________________________________________________________________________________________ Fax: ________________________________________ Email: ________________________________________________ Attorney for Respondent: _______________________________________ Telephone: ___________________________ Address: __________________________________________________________________________________________ Fax: ________________________________________ Email: ________________________________________________ GAL / AFC / CR Name: _________________________________________ Telephone: ___________________________ Address: __________________________________________________________________________________________ Fax: ________________________________________ Email: ________________________________________________ _______________________________ Dated Prepared by: _______________________________ Attorney for: _______________________________ ____________________________________________________ JUDGE Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com