Mediation Case Information Form (Statewide Civil General Equity And Probate Mediation Program) Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Mediation Case Information Form (Statewide Civil General Equity And Probate Mediation Program) Form. This is a New Jersey form and can be use in Civil Division Statewide.
Loading PDF...
Tags: Mediation Case Information Form (Statewide Civil General Equity And Probate Mediation Program), 10526, New Jersey Statewide, Civil Division
FOR OFFICE USE ONLY
State of New Jersey
DATE RECEIVED:
MEDIATION CASE INFORMATION FORM
DATE ENTERED - AOC:
Statewide Civil, General Equity and Probate Mediation Program
DIRECTIONS: This form is to be completed by the mediator when the mediation is concluded or returned to court.
CASE DOCKET NUMBER
COUNTY
LAST NAME OF MEDIATOR
FIRST NAME OF MEDIATOR
OUTCOME / NATURE OF AGREEMENT
mediation held / full agreement on all issues
mediation held / no agreement
no mediation held / party failed to attend
mediation held / some issues pending
no mediation held / parties settled
case before mediation session
no mediation held / party attended but
failed to participate
SOURCE OF REFERRAL
MANNER OF MEDIATOR SELECTION
motion / request of
plaintiff
bench
referral
DATE CASE ASSIGNED
TO MEDIATOR
motion / request of
defendant
consent request
by both parties
DATE OF INITIAL
MEDIATION SESSION
NUMBER OF MEDIATION
SESSIONS
DID THE ATTORNEYS
SUBMIT PROPER
CASE SUMMARIES?
NUMBER OF HOURS
IN SESSIONS
WERE THE ATTORNEYS
PREPARED FOR THE
MEDIATION SESSIONS?
no
AT WHAT STAGE IN THE CASE DID
THE MEDIATION SESSION TAKE
PLACE? (note all that are applicable)
selected by parties
DATE OF FINAL
MEDIATION SESSION
NUMBER OF HOURS OF
PREPARATION TIME
yes
assigned by court
yes
no
NUMBER OF HOURS
PAID BY PARTIES
WERE THE PARTIES
PREPARED FOR THE
MEDIATION SESSIONS?
yes
no
before depositions
after experts' reports served
after interrogatories and
document production
WAS THE TIMING OF REFERRAL
TO MEDIATION APPROPRIATE?
before any discovery
after depositions
after first trial date scheduled
too early
HAD THIS CASE UNDERGONE ANY
PRIOR CDR TECHNIQUE? (e.g.
arbitration, early neutral evaluation)
appropriate time
too late
TYPE OF CDR
yes
IF THE CASE DID NOT SETTLE IN
MEDIATION, WHAT WERE THE
REASONS? (note all that are applicable)
APPROXIMATE
DATE
no
issues were too complex
one or both parties did not
mediate in good faith
RELATIONSHIP OF
PARTIES
the proper parties with authority
to settle were not present
issues were too numerous
formal business relationship
(eg. partnership, corporation)
performance of
service contract
employee
family
one or both parties too entrenched
in their positions
friend
neighbor
no ongoing
relationship
COMMENTS (Please use this section to
note any suggestions, concerns or other
comments on the pilot program.)
PLEASE RETURN TO:
Revised 6/21/2005, CN10526-english
AOC - CIVIL PRACTICE DIVISION
BOX 981
TRENTON, NJ 08625
FAX: 609 777-0844
page 1 of 1
American LegalNet, Inc.
www.FormsWorkflow.com