Mediation by Gayle Michelle

  858.922.9608
  Gayle@GayleMichelle.com

Note:  Complete and submit this Mediation Request to initiate a mediation.  Mediation by Gayle Michelle will invite all requested attendees to participate and split any pre-approved fees. If you DON'T wish Mediation by Gayle Michelle to invite other parties, please submit the Quick Request


THE MEDIATION PROCESS IS PRIVATE AND CONFIDENTIAL 

MEDIATION REQUEST

I request Gayle Michelle invite the following parties and set an agreeable date, time, location, and desired duration for mediation where Gayle Michelle will serve as the neutral mediator.  Each party’s signature on the "Agreement to Mediate" will confirm participation, fees and logistics.  Details submitted as confidential will not be repeated without permission.  


Name
first last
Title
Company
Address
street line 1
street line 2
, city, state/prov zip
Email
Phone
Fax
1.Who are you?
2. Other party's information (number each) . For:
List CO, name, first,last, phone, e-mail, address (one per line)
For:
Check if yes
Are the participants aware this is in the works?
Are there any time constraints?
Does a mediation clause apply?
Are any attorneys attending?
Is there an E & O Insurance Carrier involved?
Is this a court ordered mediation?
Please describe all yes answers
Location, select all acceptable
MEDIATOR HOSTS
CENTRAL SAN DIEGO
Downtown San Diego
Mission Valley
University Town Square (UTC)
COASTAL SAN DIEGO
NORTH San Diego
EAST San Diego
SOUTH San Diego
Initiator Council Hosts
Respondents Council Hosts
Clients pre determined agreed location
Alternative parties choice
Type of matter
Date dispute began
Approximately, monetary value of dispute
What time frame are the parties considering?
How much time would you like to allocate?
Any Case Name/Identifier
This dispute is regarding
What is the disagreement about
What happened so far (phone calls, emails, etc.)
Please add anything else you think would be helpful for the mediator to know

Note: Please do not include any URLs in form.

Copyright ©  Gayle Michelle