Superior Court of the District of Columbia ,..:-~.,, . i.. ma , h ..~~‘&& Multi-Door Dispute Resolution Division SPECIAL MEDIATION REFERRAL Civil Branch Judge: Plaintiff/Plaintiff Attorney: (name) (address, phone) Defendant/Defendant’s Attorney: (name) (address, phone) Additional parties/counsel: (name) (address, phone) Type of case: 1 Mediator expertise needed: Mediation should be held: no later than between the following dates: Special instructions: I Please forward this form to: Karen Leichtnam, Civil ADR Branch Chief Multi-Door Division JM Annex 2001 © American LegalNet, Inc.