Follow the steps to successfully complete your mediation request.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the first section, provide the name of the party submitting the request for mediation. Include their address, telephone number, fax number, and email. Indicate whether they are the plaintiff, defendant, or another party.
3. If applicable, include information about the insurance company if the party submitting the request is defended by one. List the name of legal counsel or insurance adjustor along with their firm name, address, telephone number, fax number, and email.
4. In the second section, repeat the process for other parties involved in the dispute. Provide similar details including their name, address, contact information, and their role in the case.
5. If there are additional parties, attach a separate sheet with their information as outlined above.
6. In the third section, provide a brief description of the claim and the amount of damages being sought.
7. Indicate whether formal court pleadings have been filed by selecting 'Yes' or 'No'. If applicable, provide any discovery deadlines, arbitration dates, trial dates, the Court docket number, and the assigned judge.
8. In the fifth section, list the names of individuals who will attend the mediation with the authority to make binding decisions. Specify each person's capacity and authority.
9. Finally, submit this form along with the initial fee of $1,300.00 made payable to the Berks County Bar Association. This fee includes a $325.00 administrative charge and a $975.00 mediator's fee.
10. Once completed, save any changes made to the form. You can also download, print, or consider sharing the form as necessary.

Start filling out your request for mediation online today to take the next step in resolving your dispute.