CONFIDENTIAL MEDIATION QUESTIONNAIRE Twelfth Court of Appeals (For Court Use Only) Case Number on Appeal _____________________ Style of Case on Appeal _______________________vs_________________________ Name of your client ______________________________________________________ Your Name ______________________________________________________________ Briefly describe the nature of this case._____________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Briefly describe its mediation history, if any, to date. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Would you be opposed to trying to mediate this case while on appeal? v No, I would not be opposed. v Yes, I would be opposed because __________________________________ _______________________________________________________________ If this case were to be referred to mediation, at what stage of the appellate process do you believe it would have its best chance of settling? v Right now, before the record is produced and filed. v After the record has been filed, but before briefs are due. v After both sides have completed their research and filed their briefs, but before oral argument. v After oral argument, but prior to a decision being delivered. Additional Comments ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Thank you. American LegalNet, Inc. www.FormsWorkFlow.com