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All parties must complete, file and serve this form. Confidential information shall include: written ADR statements; documents prepared for purpose of, in the course of, or pursuant to.16.03: Alternative Dispute Resolution ("ADR") Statement and Certification. List the certified mediation training you have received. Download the ADR Mediator Application. Request for mediation (NHJB-2543-F) (DCYF and pre-adoptive parents). Recommendations for a statewide, comprehensive ADR system. Registered mediators will be billed at the time their annual statements are sent. No fee shall be required of a full-time, sitting judge. Please read the entire overview before submitting.