Alternative Dispute Resolution
Court of Appeals No. _________________________
Trial Court Style and Case
No. _________________________________________________
1. Has this case been mediated in the trial court?
Yes ___ No ___ 2. If so, was the case mediated after trial?
Yes___ No ___ 3. If applicable, who was the
mediator? __________________________________________________________________________
______________________________
4. If applicable, would you recommend using the same mediator
in this appeal?
Yes ___ No ___ 5. Please rate the case for complexity, with "1" being the
least complex (i.e., single issue in controversy, two parties) and "5" being
the most complex (multi-party, multi-issue, multi-damages). Circle one response.
1
2
3
4
5
6. If the whole case cannot be resolved through ADR,
specify which issues are amenable to such resolution:
____________________________________________________________________________________
____________________________________________________________________________________
_____________________
____________________________________________________________________________________
____________________________________________________________________________________
_____________________
____________________________________________________________________________________
____________________________________________________________________________________
_____________________ 7. If this case is not amenable to resolution on appeal through ADR,
explain:
___________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________________ ___________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________________ 8. Which ADR procedure do you prefer for this case on this appeal:
___ Mediation ___ Moderated settlement
conference ___ Arbitration
9. Is it preferable to have a mediator conversant
in a non-English language?
Yes ___
No ___ If so, what language? ____________________
_______________ 10. If you have a preferred ADR provider, state provider's name,
address, and telephone number: _____________________________________________
___________________________
_____________________________________________
___________________________
Date: ____________________
Signature:_________________________________
Printed Name:________________________________
Attorney of Record for:________________________________
State Bar Number:________________________________