COURT OF APPEAL, FIRST APPELLATE DISTRICT MEDIATION EVALUATION THIS FORM MUST BE COMPLETED BY ALL PARTIES AND THEIR COUNSEL SEE LOCAL RULE 2(d)(11) MAIL WITHIN 10 DAYS OF THE COMPLETION OF THE MEDIATION TO: GARY WEINER, MEDIATION PROGRAM ADMINISTRATOR COURT OF APPEAL, FIRST APPELLATE DISTRICT 350 McALLISTER STREET SAN FRANCISCO, CA 94102 OR FAX TO 415-865-7374 _____________________________________________________________________________________________ TODAY'S DATE: _______________________________ Case Name: _____________________________________ Your Name: _____________________________________ Type of case: ( ) Business/Contract ( ) Insurance ( ) Construction ( ) Intellectual Property ( ) Employment ( ) Medical Malpractice ( ) Family Law ( ) Personal Injury Case No: _________________ Phone Number: _________________ ( ( ( ( ) Probate ) Prof. Negligence ) Real Estate ) Other (specify): ___________ You are: ___ appellant ___ appellant's attorney ___ respondent ___ respondent's attorney ___ insurance representative ___ Other (specify): ______________________________________ How did the case resolve? (Do not reveal confidential information): ___Direct result of the mediation process ___Indirect result of the mediation process ___ Some issues resolved (how many?: _____) ___Resolution was unrelated to the mediation process ___Appeal was not resolved ___Other (specify): _____________________________ This section should be completed by counsel only: Name of the party you represent: ______________________________________________________ How many months elapsed between filing of the notice of appeal and resolution? _____ The case resolved: ___ Before ___ During record preparation ___ Before ___ During brief preparation What was the effect of the mediation process on the following (Insert "ND" if no difference): Attorney's fees: ___Reduced fees Increased fees By how much? (estimate) $__________ Other costs: ___Reduced costs Increased costs By how much? (estimate) $__________ Court time: ___Reduced time Increased time By how much? (estimate) $____ months On a scale of 1 (very dissatisfied) to 5 (very satisfied) please rate: The mediation process: The mediator (name): ____________________ ___ Appropriateness of the process for your dispute __ Impartiality ___ Fairness __ Temperament ___ Opportunity to participate __ Knowledge of the mediation process ___ Confidentiality __ Knowledge of the subject matter ___ Satisfaction with outcome Would you use this process again? __ Yes __No Would you use this mediator again? __ Yes __No Program administration: __ Efficiency (scheduling, etc.) __ Paperwork __ Courtesy and cooperation __ Mandatory participation Comments on the mediator or the process or suggestions for program improvements: 09/13/2011 American LegalNet, Inc. www.FormsWorkFlow.com