Providing Resources For Parents and Educators
Please fill out the form below.
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Thank you for participating in the mediation process. We ask that you take a few minutes to complete this
evaluation as it is important for the Office for Dispute Resolution (ODR) to receive your feedback.
Mediation Evaluation Questionnaire
1. With regard to ODR, please indicate your satisfaction with the staff explaining the mediation procedures,
contacting the parties and scheduling the mediation
Now think about the mediator in your case. Check a response which represents your opinion about the following
2.Did the mediator explain
the mediation process YesUndecidedNo
his/her role in mediation YesUndecidedNo
each party’s role in mediation YesUndecidedNo
3.Did the mediator
listen to your concerns YesUndecidedNo
understand the issues YesUndecidedNo
treat you with respect YesUndecidedNo
help you clarify and prioritize your concern YesUndecidedNo
4.Did the mediator foster an environment where
ideas and concerns could be shared YesUndecidedNo
mutual respect and understanding were encouraged YesUndecidedNo
the parties could work together to develop solutions YesUndecidedNo
anger and tension could be expressed constructively YesUndecidedNo
5.If the parties had difficulty developing solutions, did the mediator help the parties
move past serious differences YesUndecidedNo
clarify information YesUndecidedNo
problem solve YesUndecidedNo
6.Is an IEP, IFSP or service agreement meeting scheduled to accommodate any changes resulting from the mediation
7.Would you contact ODR and request mediation services for any future special education disputes? YesUndecidedNo
8.As a result of this mediation, do you feel that you have established better communication with the other party, a
better understanding of their concerns, and be able to discuss issues more openly and constructively in the future?
9.Overall, how satisfied were you with the results of mediation?
Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedNeutralNot Sure
10.Do you have any suggestions on ways to improve mediation?
Please provide any suggestions for improvement of the mediation system.
If you would like a representative from ODR to contact you to discuss this evaluation, please provide your name and contact information.
©2012 Office for Dispute Resolution • 6340 Flank Drive Harrisburg, PA 17112 • 800-222-3353