21.10 Forms


The following forms will be used in conjunction with court-annexed mediation:

Form 1:      Mediator Application and Self Certification of Qualifications

Form 2:      Order of Referral to Court-Annexed Mediation

Form 3:      Confidentiality Agreement and Nonrepresentation Acknowledgment

Form 4:      Memorandum of Agreement/No Agreement

Form 5:      Mediator Report, pursuant to Supreme Court Rule 99 as a mechanism for reporting to the Supreme Court on the  mediation program.

Form 6:      Evaluation Form, which will be kept confidential and only be used for statistical and evaluative purposes.


[Dated July 29, 2013, effective August 1, 2013.]