Screening Cases for Suitability for Mediation PLEADINGS STAGE SCREENING TOOL Case Caption: _____________________________ Case Number:_____________________________ Screening Date:___________________________ Screener (Name):__________________________ Document to be Examined Inquiry Additional Inquiry Warranted Conclusion 1. DCIR Forms A. Under the section “Alternative Dispute Resolution Information” did the party indicate NO to any form of ADR? If the party checks YES to mediation, and NO to other forms of ADR, they may be suggesting only mediation is appropriate and not other types. If they check NO to some types of ADR, but there appear to be no references to family violence issues, and no indication as to why mediation is not appropriate, it may be necessary to telephone counsel or the party for clarifying information. G Party or counsel believes [EXAMINE DCIRs ATTACHED TO BOTH THE COMPLAINT AND THE ANSWER] G Party or counsel identified the B. Under the final section “Is there an allegation of physical or sexual abuse of party or child?” the party or counsel have indicated “YES.” 2. Complaint / Countercomplaint, Petition or Motion [EXAMINE THE INITIAL PLEADINGS OR OTHER RELEVANT DOCUMENTS FILED BY BOTH PARTIES] A. Related Case Information: I. Does the party list any domestic violence, peace order cases, Child In Need of Assistance cases from Maryland or other states that might suggest there has been a history of family violence? mediation is inappropriate because of family violence issues or other safety concerns. presence of abuse allegations. If the cases are old, it might be appropriate to contact counsel to gauge their sense of whether mediation is appropriate. G There are cases known to the court that suggest a history of family violence. If either party is selfrepresented it might be advisable to call the parties or bring the parties in for individual in-person screenings. II. Does the party list any related domestic cases or other case types? Page 1 of 2 If the party lists other related cases, it might be necessary to look those up in the court’s information system to see if they include allegations of domestic violence or child abuse, or suggest a history of family violence. American LegalNet, Inc. www.USCourtForms.com CM 18 - July 2005 2. Complaint / Countercomplaint, Petition or Motion (continued) G The grounds for divorce B. Grounds (Divorce Cases only): I. Does either party seek a divorce on the grounds of cruelty or excessively vicious conduct against him or herself or the minor child? suggest that there is a history of family violence. II. Does either party seek a divorce on the grounds of criminal conviction where the underlying complaint stems from family violence or abuse of a child? III. Does either party seek a divorce on the grounds of constructive desertion where the underlying allegations refer to family violence or abuse of a child? C. Allegations: Read the factual allegations detailed in the petition. Does the party state any facts that suggest that the complaining party, the opposing party or a child have been the victim of abuse, or are at risk of harm? G A party has alleged facts D. Forms of Relief: Even when a party has not stated that they or their children have been a victim of family violence, or are at risk of harm, they may seek forms of relief which put the court on notice. Does the party request some type of stay-away order, no contact provision, or protection from threats or actual harm? 3. Answer If facts are alleged that raise a concern about the safety of either party or a child, but it is not clear whether or not there is risk, it may be wise to request both parties appear in court for an individual, in-person safety screening. If some type of protective relief is requested, but no facts are stated that support those forms of relief, it may be wise to request both parties appear in court for an individual, in-person safety screening. G A party has requested A. Affirmations, Denials and Other Allegations: I. Does the answering party confirm allegations of abuse? which suggest that one or more parties, or a child may have been a past victim of violence or at risk of future harm. protective relief of some type, suggesting that there is a history of family violence. G The answering party affirms or has not denied allegations suggesting a history of family violence or future risk of harm. G The answering party has II. Does the answering party allege new facts that suggest a history of family violence or future risk of harm? alleged new facts suggesting a history of family violence or future risk of harm. G The answering party has identified cases suggesting a history of family violence. III. Does the answering party refer to any other related cases that suggest a history of family voilence? 4. Other Documents Review other documents in the file that may be relevant to determining if there are family violence issues that would suggest the case was inappropriate for mediation. G Other documents in the file suggest the presence of family violence issues. NOTE TO SCREENER: If one or more conclusions are checked, the case is NOT appropriate for mediation. G Based on a review of pleadings only, this case MAY BE APPROPRIATE for mediation or other forms of ADR. G This case is NOT APPROPRIATE for mediation or other forms of ADR. G This case requires in-person, individualized screenings to determine if mediation or ADR would be appropriate. NOTE: This screening was based on a review of the pleadings only and may NOT have identified all possible domestic violence issues. American LegalNet, Inc. www.USCourtForms.com Page 2 of 2 CM 18 - July 2005