Court of Appeal, First Appellate District Mediator’s Statement PLEASE 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 Please complete this statement without breaching confidentiality. TODAY’S DATE: _______________________________________ Case Name: _____________________________________________ Case No: _________________ Your Name: _______________________________________ Phone Number: _________________ Type of case: ( ) Attorney’s Fees ( ) Family Law ( ) Partnership ( ) Business /Contract ( ) Health Care ( ) Personal Injury ( ) Construction ( ) Housing ( ) Probate ( ) Defamation ( ) Insurance ( ) Professional Negligence ( ) Eminent Domain ( ) Intellectual Property ( ) Public Entity ( ) Employment/Labor ( ) Landlord/Tenant ( ) Real Estate ( ) Environment ( ) Medical Malpractice ( ) Securities Other (specify):_________________________________________________________________________ Preparation time (in tenths):________ hours Total session time (in tenths): ________ hours No. of sessions:______ Follow-up time (in tenths): _________ hours Total mediation fee for all parties (if any): $ ___________ Total expenses (if any): $ __________ How did the case resolve? ___ Full resolution ___ Resolution of some issues (How many? _____) ___ No resolution ___ Other (specify) ____________________________________________________________________ If the mediation resolved more than one dispute, check all that were resolved: ___ Another appeal ___ A trial court matter ___ A matter not in litigation Was your primary style in this case ____ Facilitative ____ Evaluative ____Directive? Were counsel ____ Appellate attorneys ____ Both? ____ Yes ____ No ____ Trial attorneys Did you distribute evaluation forms? On a scale of 1 (very dissatisfied) to 5 (very satisfied) please rate the court’s mediation program as to: ___ Efficiency (scheduling, etc.) ___ Courtesy and cooperation ___ Paperwork ___ Pro bono requirement Comments on the above, including suggestions for program improvements: 09/13/2011 American LegalNet, Inc. www.FormsWorkFlow.com