School/Education Issues Intake Form

 

Name
first last
Email
Case Name
Date Lawsuit Filed
Venue
Case Number
CASE HAS NOT BEEN FILED
No
Does this case involve bullying? If yes, please answer the following questions
Yes
No
Type of Bullying
Age Difference of Above
Your Name (Required)
Telephone Number (Required)
Your Firm's Name
PREFERRED DATES FOR MEDIATION: (Please List Two dates if you can)
First Choice
Second Choice
Preferred Location for Mediation
OPPOSING COUNSEL’S INFORMATION
Name
Firm's Name
Telephone Number
Any Prior Mediations?
Yes
No
If Yes, Dates of Prior Mediations
Mediators Name
Mediator's Telephone Number
Verification (to make sure you're human)

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