Mediator Report (Form 6) (3/09/04) CCL 0132 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION ____________________________________________________ Plaintiff(s) v. ____________________________________________________ Defendant(s) } 3488 No. ________________________________ _______________________________ Judge Judge’s No. MEDIATOR REPORT (To be completed at the end of each mediation and filed with the Court, with a courtesy copy delivered to the CourtAnnexed Civil Mediation Supervisor, pursuant to Illinois Supreme Court Rule 99 as a mechanism for reporting to the Supreme Court on the mediation program.) Case Number: ____________________________ Mediator Name: _____________________________________ Case Type: Personal Injury Medical Malpractice Products Liability General Tort Commercial Construction Real Property Disputes Employment/Wrongful Termination Probate Chancery Other (list below) ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ The undersigned mediator, selected by the attorney/s appointed by the Court pursuant to the Order entered on the________ day of ____________________________, _________ reports to the Court as follows: A. B. A settlement of this matter has been reached has been reached in part has not been reached (If a settlement was reached) The party designated to prepare the settlement agreement and stipulation to dismiss is ______________________ _______________________________; to be submitted to the court by __________________________, ________ (Date) C. Date mediation began:______/______/______ Date ended:______/______/______ Number of sessions: _______ D. Hours in mediation:__________ Hours of preparation:__________ E. How many from each category attended? _______ Lawyers _______ Clients _______ Non-Parties (please list, e.g., witnesses, spouse) ____________________ __________________________________________________________________________________ __________________________________________________ Dated: ____________________________, _________ Signature of Mediator DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Print This Form For your protection and privacy, please press the Clear This Form button after you have printed the form. Clear This Form