Post Mediation Survey

Questions marked with a * are required
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Please take a moment to answer this brief survey. Your feedback is important to us.
Please indicate Court File Number/Index Number:
Please indicate case type:
Indicate whether you were:
What was your role:
Did you reach an agreement?
If you did not reach an agreement, do you think you made progress?
If more than one Mediator, was the co-mediation experience positive?
Please share your opinion about each statement below:
Is there anything else you would like to tell us about the Mediator(s) or your experience?
May we contact you within 6 months to follow up?
If yes, please provide your contact Information below:
Date: