U.S. DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS (WESTERN DIVISION) MEDIATION EVALUATION FORM --For Mediators-- Please fill out this form and email it to the Clerk's Office, at adr@ilnd.uscourts.gov, within 10 days of the mediation session. No case identification will be associated with these responses for purposes other than program evaluation. Name: Case Number: Date of Mediation: Type of Case: Outcome: Settled Partially settled Not settled Continued for further mediation Overall, how helpful or detrimental was the mediation in the resolution of this case? Very helpful Somewhat helpful It had little impact on the case Somewhat detrimental Very detrimental Number of cases for which you have acted as a mediator prior to this one: The overall length of mediation was: Too long Too short About right Do you think the assignment of this case to mediation: Helped the case resolve more quickly Will increase the time it takes to resolve the case Will have no effect on the time it takes to resolve the case Do you think the assignment of this case to mediation: Has reduced (or will reduce) litigation costs to the parties Will increase litigation costs to the parties Will have no effect on costs to the parties American LegalNet, Inc. www.FormsWorkFlow.com Please respond to the following: Strongly Disagree This case was appropriate for mediation: This case was referred to mediation at the appropriate time: The lawyers were prepared for mediation: The litigants were prepared for mediation: The litigants were actively involved in the mediation: The mediation helped narrow or clarify the issues involved in this case: I have expertise in this type of dispute: Overall, I am satisfied with what was accomplished in the mediation: Disagree Neutral Agree Strongly Agree If the case did not settle, why not? Please check each action you undertook in the mediation: focused on legally relevant issues gave primacy to parties' needs and interests focused on the evidence of the case focused on the parties' perception of the case gave an advisory opinion of the likely outcome helped parties determine strengths and weaknesses of the case provided parties with a particular settlement proposal or range helped parties generate their own options American LegalNet, Inc. www.FormsWorkFlow.com Comments on the program: American LegalNet, Inc. www.FormsWorkFlow.com