Get Mediation Intake Form

Filling out the Mediation Intake Form is an essential step in the mediation process, providing the necessary information for assessment and support. This guide will walk you through the online completion of the form, ensuring you have a clear understanding of each section.

Follow the steps to complete the Mediation Intake Form online.

1. Click ‘Get Form’ button to obtain the form and open it in your editor. This will allow you to access all necessary fields for completion.
2. Begin by filling in your personal information. Enter your full name, the current date, and your address, including city, state, and ZIP code.
3. Provide your contact details. List your home phone, cell phone, work phone, and email address to ensure effective communication.
4. Include your employment information. State the name of your employer, your position, whether you work full time or part time, how many years you have been employed, and your date of birth.
5. Fill in your spouse's name, the date and city of your marriage, and the date of separation.
6. List the names and ages of your children, and indicate with whom they are currently living.
7. Address any history of abuse in the marriage by selecting 'Yes' or 'No'. If there was abuse, indicate the type: Physical, Emotional, Chemical, or Other.
8. State whether there is an Order for Protection or Restraining Order in place.
9. Indicate your counseling or therapy status. If applicable, describe the type of treatment, the provider, and how long you have been engaged in this support.
10. If you have an attorney, provide their name and specify whether you have retained them or if you are only consulting.
11. Note how you found out about the mediation services, and if referred by someone, specify if a thank you note can be sent.
12. Lastly, articulate your area of greatest concern regarding the divorce.
13. After completing the form, ensure all information is accurate, then save your changes, and consider downloading, printing, or sharing the form as needed.

Complete your mediation documents online today for a smoother process.