Client Intake Form – Part I Basic Information

 

  • Is Mediation Right For You?  We encourage you to ask your self these two questions.  First, can I work with my spouse cooperatively, with the assistance of a mediator, and negotiate an agreement and save the costly expenses of contested divorce litigation?  Second, has my contested divorce litigation stalled or gone out of control and can I work with my spouse cooperatively with the assistance of a mediator.  If you answered yes to either of these questions it may be time to mediate your divorce and negotiate an agreement directly with your spouse and save the ongoing costly expenses of contested divorce litigation?
  • Online mediation total costs are $1,125.00 for online virtual mediation or $1,500.00 for in-office mediation.  Both include a typed complete agreement, typically 20 to 50 pages, with all issues resolved, prepared by our mediators and ready for your signature or, if you have an attorney, for their review. Begin the process now for FREE by completing our online intake interview by clicking here.

Complete and submit the below Intake Form now to begin the process for free.  Use your Last Name as your Unique ID.

Client Intake Form - Part I Basic Information

Security







Type of Divorce Mediation Interested In - On-Line $1,125.00 or In Office $1,500.00.
$1,125.00$1,500.00

Children


NoneOneTwoThreeFourFive










































Wife's Information:















Husband's Information: