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Court Mediation Survey Form. This is a California form and can be use in Contra Costa Local County.
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Tags: Court Mediation Survey, California Local County, Contra Costa
SUPERIOR COURT OF CALIFORNIA, CONTRA COSTA COUNTY
ALTERNATIVE DISPUTE RESOLUTIONS PROGRAM OFFICE
We value your comments — Thanks for taking 5 minutes to complete this survey!
Please return this form to: ADR Programs, P.O. Box 911, Martinez, CA 94553 Fax: (925) 957-5689
COURT MEDIATION SURVEY
Case Name: ______________________________________________
Case No.: ________________
1. Please tell us your relationship to this case.
Defendant (person being sued)
Plaintiff (person filing lawsuit)
Counsel for Plaintiff
Counsel for Defendant
Other _________________
(Please specify – e.g.: claims rep)
2. Please check the box next to the best answer for each question.
a. Was this case resolved in mediation?
YES
NO
b. If no, did the mediation help you to reach an agreement later?
YES
NO
c. Did you resolve some of the issues in mediation?
YES
NO
d. Did the mediator make recommendations about the value of your case, or
how you should settle your case?
YES
NO
e. Was the mediator fair? (not biased for or against anyone)
YES
NO
f. Were you able to explain your position fully?
YES
NO
g. Do you think the mediator understood the important issues?
YES
NO
h. Did mediation lower the cost of resolving this case?
YES
NO
i. Did mediation reduce the time needed to resolve this case?
YES
NO
3. How would you rate this mediation experience?
Excellent
Good
Fair
4. Was the referral to mediation
Too early
About right
Poor
Too late
5. If you reached an agreement in mediation, how would you rate the agreement?
Excellent
Good
Fair
Poor
6. How many times have you used mediation?
0
1-5
6-10
more than 10 times
7. How did this experience compare to other disputes where you did not use mediation?
Much better
Better
About the same
Worse
Doesn’t apply
8. Would you use mediation again or recommend it to others?
Yes
No
Do you have comments or suggestions?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
May we share your responses / comments with the mediator?
Yes
No
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ADR Revised 2/16/11