Evaluation: Mediation Form

Mediation Session Date.:*

LEA (Local Education Agency):*

Name of Mediator*

Please identify your role:*

1) Please rate your overall experience with mediation.*

Additional Comments.

2) Please rate your overall experience with the mediator.*

Additional Comments.

3) Please rate your overall experience with the coordination services provided by ODR.*

Additional Comments.

4) Do you have suggestions for improving the mediation services provided by ODR?*

Thank You for providing feedback on your recent Mediation. Please scroll to the bottom of the page and press "submit"

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